title: Catch-up growth in the first two years of life in Extremely Low Birth Weight (ELBW) infants is associated with lower body fat in young adolescence.
abstract: OBJECTIVE
  To investigate growth patterns and anthropometrics in former extremely low birth weight (ELBW, <1000 g) children and link these outcomes to neurocognition and body composition in childhood.
  
  
  METHODS
  ELBW children were examined at birth (n = 140), at 9 and 24 months (n≥96) and at approximately 11 years within the framework of the PREMATCH (PREMATurity as predictor children's of Cardiovascular and renal Health) case-control (n = 93-87) study. Regional growth charts were used to convert anthropometrics into Z-scores. Catch-up growth in the first two years of life was qualified as present if ΔZ-score >0.67 SDS. At 11 years, anthropometrics, neurocognitive performance, body composition, grip strength and puberty scores were assessed.
  
  
  RESULTS
  ELBW neonates displayed extra-uterine growth restriction with mean Z-scores for height, weight and head circumference of -0.77, -0.93 and -0.46 at birth, -1.61, -1.67 and -0.72 at 9 months, -1.22, -1.61 and -0.84 at 24 months, and -0.42, -0.49 and -1.09 at 11 years. ELBW children performed consistently worse on neurocognitive testing with an average intelligence quotient equivalent at 11 years of 92.5 (SD 13.1). Catch-up growth was not associated with neurocognitive performance. Compared to controls, ELBW cases had lower grip strength (13.6 vs. 15.9 kg) and percentage lean body weight (75.1 vs. 80.5%), but higher body fat (24.6 vs. 19.2%) and advanced puberty scores at 11 years (all P≤0.025). Catch-up growth for weight and height in the first two years of life in cases was associated with a lower percentage body fat compared to cases without catch-up growth (16.8% catch-up growth for weight vs. 25.7%, P<0.001; 20.9% catch-up for height vs. 25.8%, P = 0.049).
  
  
  CONCLUSIONS
  In young adolescence, former ELBW children still have difficulties to reach their target height. Compared to normal birth weight controls, ELBW adolescents show lower neurocognitive performance and grip strength and a higher percentage body fat, a potential risk factor for adverse health outcomes in adulthood. Our key finding is that catch-up growth in ELBW children in the first two years of life is associated with a lower percentage body fat and is therefore likely to be beneficial.
authors.affiliation: Department of Pediatrics and Neonatology, University Hospitals Leuven, Leuven, Belgium.|KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium.
authors.forename: Anke
authors.identifier: http://orcid.org/0000-0001-8846-1650
authors.initials: A
authors.lastname: Raaijmakers
authors.affiliation: Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Lotte
authors.initials: L
authors.lastname: Jacobs
authors.affiliation: Department of Pediatrics and Neonatology, University Hospitals Leuven, Leuven, Belgium.|KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium.
authors.forename: Maissa
authors.initials: M
authors.lastname: Rayyan
authors.affiliation: Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Theun Pieter
authors.initials: TP
authors.lastname: van Tienoven
authors.affiliation: Department of Pediatrics and Neonatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Ortibus
authors.affiliation: Department of Pediatrics and Neonatology, University Hospitals Leuven, Leuven, Belgium.|KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium.
authors.forename: Elena
authors.initials: E
authors.lastname: Levtchenko
authors.affiliation: Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.|R&D Group VitaK, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
authors.affiliation: KU Leuven Department of Development and Regeneration, University of Leuven, Leuven, Belgium.|Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Karel
authors.initials: K
authors.lastname: Allegaert
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000293:Adolescent; D001823:Body Composition; D001827:Body Height; D001835:Body Weight; D003071:Cognition; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development* / Q000502:physiology; D007231:Infant, Newborn; D008297:Male