SPONTANEOUS GROWTH AND FINAL HEIGHT IN SGA INFANTS

Abstract

Small for gestational age (SGA) infants are a high risk group in respect of postnatal mortality, morbidity and/or disturbed development, although little is known about me long term effects. The aim of this work was to define the risk for SGA infants of being short in higher ages and to compare this risk when using birth length and birth weight in the definition of SGA. The material consists of all children (n=4500) being in the last class in school, Göleborg, Sweden. Perinatal information was collected from the birth register and growth and health data from the child health care units and the schools. SGA infants, i.e. shorter than −2SDS at birth was found to represented 20 - 25% of the short children in higher ages. However, the risk of being short was much higher in SGA infants than in non-SGA infants; 9 times higher at 3 years and 5 times higher at 8 years of age. Birth length appeared to be twice as sensitive than birth weight in predicting postnatal shortness. Four different postnatal growth patterns were identified in SGA; catch-up growth (1) before 6 months of age in 40%, (2) before 3 years of age in 25%, (3) after 3 years of age in 20%, and (4) without any catch up growth in 15%. The mean final height SDS in the first two groups were close to the mean midparental height SDS, but not for group 3 and 4. This study is the first to describe the spontaneous postnatal growth patterns and final height in SGA infants. Catch-up growth was usually seen before 3 years of age. The SGA- children still being short at 3 years of age reached a final height below their genetic potential, independently of the existence of a slow catch-up growth after 3 years of age, or not.

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