Abstract
According to Barker's hypothesis, children born small for gestational age (SGA) are at increased risk for cardiovascular diseases in adulthood. The aim of our study was to determine whether retarded fetal growth is associated with dyslipidemia in childhood and, if so, to find predictive factors in the growth characteristics of SGA children. We studied the serum lipid concentrations of 55 SGA children and their 55 appropriate for gestational age control subjects at the age of 12 y. Growth variables were recorded at birth, 5 y, and 12 y of age. The study group consisted of all full-term SGA children born at our university hospital during a 22-mo period in 1984–1986. Nearly half of the SGA children (47.3%) were in the highest quartile for serum total cholesterol of the appropriate for gestational age children (p = 0.038). In multiple logistic regression analysis, poor catch-up growth in height (odds ratio, 13.8; 95% confidence interval, 2.0–97.5), female sex (odds ratio, 8.1; 95% confidence interval, 1.3–48.9), and early stage of puberty (odds ratio, 7.5; 95% confidence interval, 1.2–46.5) predicted high cholesterol level in the SGA children. By the age of 5 y, 20 (36.4%) SGA children showed catch-up growth of ≥ 2 SD scores in height, and 21 (38.2%) SGA children showed catch-up growth of ≥ 2 SD scores in weight from birth. At the age of 12 y, the SGA children were still significantly shorter (p < 0.001) and lighter (p < 0.05) than the appropriate for gestational age children, even though their pubertal development was similarly advanced. In conclusion, to be born SGA has long-term consequences for later growth and may already influence the level of serum total cholesterol before the teens. SGA children with poor catch-up growth in height may be at the highest risk for hypercholesterolemia.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- SGA:
-
small for gestational age
- AGA:
-
appropriate for gestational age
- TC:
-
total cholesterol
- PSEH:
-
parent-specific expected height
- TG:
-
triglycerides
References
Tracy RE, Newman WP, Wattigney WA, Srinivasan SR, Strong JP, Berenson GS 1995 Histologic features of atherosclerosis and hypertension from autopsies of young individuals in a defined geographic population: the Bogalusa heart study. Atherosclerosis 116: 163–179.
Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA 1998 Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 338: 1650–1656.
Sporik R, Johnstone JH, Cogswell JJ 1991 Longitudinal study of cholesterol values in 68 children from birth to 11 years of age. Arch Dis Child 66: 134–137.
Lauer RM, Lee J, Clarke WR 1988 Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine study. Pediatrics 82: 309–318.
Porkka KV, Viikari JS, Taimela S, Dahl M, Åkerblom HK 1994 Tracking and predictiveness of serum lipid and lipoprotein measurements in childhood: a 12-year follow-up. Am J Epidemiol 140: 1096–1110.
Barker DJP, Hales CN, Fall CHD, Osmond C, Phipps K, Clark PMS 1993 Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia 36: 62–67.
Barker DJP, Fall CHD 1993 Fetal and infant origins of cardiovascular disease. Arch Dis Child 68: 797–799.
Barker DJP 1994 Outcome of low birth weight. Horm Res 42: 223–230.
Barker DJP 1997 Intrauterine programming of coronary heart disease and stroke. Acta Paediatr Suppl 423: 178–182.
Barker DJP, Osmond C, Simmonds SJ, Wield GA 1993 The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life. BMJ 306: 422–426.
Barker DJP, Gluckman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS 1993 Fetal nutrition and cardiovascular disease in adult life. Lancet 341: 938–941.
Forsen T, Eriksson JG, Tuomilehto J, Teramo K, Osmond C, Barker DJP 1997 Mother's weight in pregnancy and coronary heart disease in a cohort of Finnish men: follow up study. BMJ 315: 837–840.
Barker DJP, Martyn CN, Osmond C, Hales CN, Fall CHD 1993 Growth in utero and serum cholesterol concentrations in adult life. BMJ 307: 1524–1527.
Donker G, Labarthe D, Harrist R, Selwyn B, Srinivasan S, Wattigney W, Berenson G 1997 Low birth weight and serum lipid concentrations at age 7–11 years in a biracial sample. Am J Epidemiol 145: 398–407.
Antal M, Agfalvi R, Nagy K, Szepvölgyi J, Banto E, Regöly-Merei A, Biro L, Biro GY 1998 Lipid status in adolescents born with low birth weight. Z Ernährungswiss 37( suppl): 131–133
Ibanez L, Potau N, deZegher F 1999 Precocious pubarche, dyslipidemia, and low IGF binding protein-1 in girls: relation to reduced prenatal growth. Pediatr Res 46: 320–322.
Albertsson-Wikland K, Boguszewski M, Karlberg J 1998 Children born small-for-gestational age: postnatal growth and hormonal status. Horm Res 49: 7–13.
Karlberg J, Albertsson-Wikland K 1995 Growth in full-term small-for-gestational-age infants: from birth to final height. Pediatr Res 38: 733–739.
Luo Z-C, Albertsson-Wikland K, Karlberg J 1998 Length and body mass index at birth and target height influences on patterns of postnatal growth in children born small for gestational age. Pediatrics 102: e72
Leger J, Limoni C, Collin D, Czernichow P 1998 Prediction factors in the determination of final height in subjects born small for gestational age. Pediatr Res 43: 808–812.
Salomaa V, Miettinen H, Kuulasmaa K, Niemelä M, Ketonen M, Vuorenmaa T, Lehto S, Palomäki P, Möhönen M, Immonen-Räihä P, Arstila M, Kaarsalo E, Mustaniemi H, Torppa J, Tuomilehto J, Puska P, Pyörälä K 1996 Decline of coronary heart disease mortality in Finland during 1983 to 1992: roles of incidence, recurrence and case-fatality. The FINMONICA MI register study. Circulation 94: 3130–3137.
Pihkala J, Hakala T, Voutilainen P, Raivio K 1989 New Finnish fetal growth charts [in Finnish]. Duodecim 105: 1540–1546.
Dubowitz LM, Dubowitz V, Goldberg C 1970 Clinical assessment of gestational age in the newborn infant. J Pediatr 77: 1–10.
Salo MK, Viikari J, Nuutinen M, Kaitila I, Sipilä I, Åkerblom H, Komulainen J, Siimes M, Simell O 1994 Diagnosis and treatment in hypercholesterolemia and other dyslipidemias in childhood [in Finnish]. Duodecim 110: 1719–1723.
Pere A, Perheentupa J, Peter M, Voutilainen R 1995 Follow up of growth and steroids in premature adrenarche. Eur J Pediatr 154: 346–352.
Martikainen MA 1988 Outcome of babies born to hypertensive mothers. PhD thesis, Kuopio University, Kuopio, Finland
Herrg˚ard E 1993 Neurodevelopmental profile at the age of five years of children born preterm at ≤ 32 weeks of gestation. PhD thesis, Kuopio University, Kuopio, Finland
Marshall WA, Tanner JM 1969 Variations in pattern of pubertal changes in girls. Arch Dis Child 44: 291–294.
Marshall WA, Tanner JM 1970 Variations in pattern of pubertal changes in boys. Arch Dis Child 45: 13–16.
Central Statistical Office of Finland 1989 Classification of socio-economic groups [in Finnish]. Hakapaino Press, Helsinki
Friedewald WT, Levy RJ, Fredrickson DS 1972 Estimation of the concentration of low-density-lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem 18: 499–502.
Albertsson-Wikland K, Wennergren G, Wennergren M, Vilbergsson G, Rosberg S 1993 Longitudinal follow-up of growth in children born small for gestational age. Acta Paediatr 82: 438–443.
Albertsson-Wikland K, Karlberg J 1994 Natural growth in children born small for gestational age with and without catch-up growth. Acta Paediatr Suppl 399: 64–70.
Hokken-Koelega ACS, De Ridder MAJ, Lemmen RJ, Den Hartog H, De Muinck Keizer-Schrama SMPF, Drop SLS 1995 Children born small for gestational age: do they catch up?. Pediatr Res 38: 267–271
Porkka KV, Viikari JS, Rönnemaa T, Marniemi J, Åkerblom HK 1994 Age and gender specific serum lipid and apolipoprotein fractiles of Finnish children and young adults. The Cardiovascular Risk in Young Finns Study. Acta Paediatr 83: 838–848.
Eriksson JG, Forsen T, Tuomilehto J, Winter PD, Osmond C, Barker DJP 1999 Catch-up growth in childhood and death from coronary heart disease: longitudinal study. BMJ 318: 427–431.
Porkka KV, Raitakari OT, Leino A, Laitinen S, Räsänen L, Rönnemaa T, Marniemi J, Lehtimäki T, Taimela S, Dahl M, Uhari M, Åkerblom HK, Viikari JSA 1997 Trends in serum lipid levels during 1980–1992 in children and young adults. The Cardiovascular Risk in Young Finns Study. Am J Epidemiol 146: 64–77.
Author information
Authors and Affiliations
Additional information
Supported by Pediatric Research Foundation, Kuopio University Hospital, and Academy of Finland.
Rights and permissions
About this article
Cite this article
Tenhola, S., Martikainen, A., Rahiala, E. et al. Serum Lipid Concentrations and Growth Characteristics in 12-year-old Children Born Small for Gestational Age. Pediatr Res 48, 623–628 (2000). https://doi.org/10.1203/00006450-200011000-00012
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/00006450-200011000-00012
This article is cited by
-
Effects of Growth Hormone Treatment on Lipid Profiles
The Indian Journal of Pediatrics (2018)
-
Growth hormone treatment for short stature in children born small for gestational age
Advances in Therapy (2008)
-
Early neonatal dexamethasone treatment for prevention of bronchopulmonary dysplasia. Randomised trial and meta-analysis evaluating the duration of dexamethasone therapy
European Journal of Pediatrics (2005)
