title: Growth in small-for-gestational-age preterm-born children from 0 to 4 years: the role of both prematurity and SGA status.
abstract: BACKGROUND
  Fullterm small-for-gestational-age children (SGAs) are known for their ability to catch up on growth. Nevertheless, increased risk of growth restriction remains. Evidence on preterm SGA children's growth is lacking.
  
  
  OBJECTIVE
  To determine absolute gains in height and weight, relative growth, and growth restriction in preterm SGAs from 0 to 4 years and how prematurity and SGA status affect these measures.
  
  
  METHODS
  Community-based cohort study, n = 1,648 preterm-born (gestational age <36 weeks, 57 SGA) and 605 term-born (12 SGA). We defined SGA as a birth weight less than -2 SD (P 2.3) compared to counterparts matched for gestational age. Height, weight, and head circumference were obtained from medical records and translated to z-scores. We defined growth restriction as height or weight less than -2 SD compared to fullterm appropriate-for-gestational-age children (AGAs).
  
  
  RESULTS
  Absolute height and weight gains were similar, but the relative growth of preterms and fullterms differed. Preterm AGAs and fullterm SGAs, although not reaching it, caught up towards the fullterm AGA median (z-scores at 4 years: -0.3 to -1.0). By contrast, preterm SGA children's z-scores were still -1.4 to -1.7. Head circumference growth was less affected by prematurity and SGA birth (z-scores at 1 year: 0.1 to -0.7). Catch-up growth mainly took place during infancy. 30-39% of all preterm SGAs showed growth restriction at 4 years.
  
  
  CONCLUSIONS
  Growth in preterm SGAs is affected considerably by the joint effects of preterm birth and SGA status, resulting in a high proportion of growth restriction.
authors.affiliation: Division of Neonatology, Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. i.tjeertes@umcg.nl
authors.forename: Inger F A
authors.initials: IF
authors.lastname: Bocca-Tjeertes
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
authors.forename: Jorien M
authors.initials: JM
authors.lastname: Kerstjens
authors.forename: Andrea F
authors.initials: AF
authors.lastname: de Winter
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
mesh_terms: D001827:Body Height; D001835:Body Weight; D002508:Cephalometry; D016009:Chi-Square Distribution; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006130:Growth Disorders / Q000209:etiology* / Q000503:physiopathology; D006257:Head / Q000254:growth & development; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors