title: Growth and predictors of growth restraint in moderately preterm children aged 0 to 4 years.
abstract: OBJECTIVE
  To describe growth in moderately preterm-born children, determine the prevalence of growth restraint at the age of 4, and identify predictors of growth restraint. We hypothesized that growth in moderately preterm-born children differs from growth in term-born children and that growth restraint is more prevalent in those born prematurely.
  
  
  METHODS
  This was a community-based cohort study of 1123 children born moderately prematurely (gestational age [GA]: 32-35 6/7 weeks) between January 2002 and June 2003.
  
  
  RESULTS
  On average, we found that moderately preterm-born children were shorter and weighed less at each assessment during the first 4 years of life than their term-born counterparts. Thirty-two boys (5.6%) and 18 girls (3.8%) were growth-restricted in height, and 21 boys (3.4%) and 27 girls (5.8%) were growth-restricted in weight. Their growth in head circumference was normal compared with term-born children. In addition, growth restraint was associated with being small for GA at birth (odds ratio [OR] for height: 7.7 [95% confidence interval (CI): 2.9-20.4]; OR for weight: 9.5 [95% CI: 3.9-23.1]) and maternal height below -1 SD (OR for height: 4.9 [95% CI: 2.6-10.2]; OR for weight: 2.6 [95% CI: 1.3-5.2]). Poor head-circumference growth was associated with a low level of maternal education (OR: 5.3 [95% CI: 1.4-20.8]).
  
  
  CONCLUSIONS
  Growth in moderately preterm-born children significantly differs from that of term-born children. Predictors at birth are being small for GA, maternal height below -1 SD, and a low level of maternal education. The fact that growth in moderately preterm-born children may lag warrants close monitoring during routine practice. Additional research on prevention of growth restraint is needed.
authors: Division of Neonatology, Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands. i.tjeertes@bkk.umcg.nl
authors: Inger F A
authors: IF
authors: Bocca-Tjeertes
authors: Jorien M
authors: JM
authors: Kerstjens
authors: Sijmen A
authors: SA
authors: Reijneveld
authors: Andrea F
authors: AF
authors: de Winter
authors: Arend F
authors: AF
authors: Bos
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001827:Body Height; D001835:Body Weight; D002508:Cephalometry / Q000379:methods; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006130:Growth Disorders / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008423:Maternal Age; D009426:Netherlands; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D012016:Reference Values; D012044:Regression Analysis; D018570:Risk Assessment; D012737:Sex Factors; D012959:Socioeconomic Factors; D047929:Term Birth