Abstract
Today we lack knowledge if size at birth and gestational age interact regarding postnatal growth pattern in children born at 32 gestational weeks or later. This population-based cohort study comprised 41,669 children born in gestational weeks 32–40 in Uppsala County, Sweden, between 2000 and 2015. We applied a generalized least squares model including anthropometric measurements at 1.5, 3, 4 and 5 years. We calculated estimated mean height, weight and BMI for children born in week 32 + 0, 35 + 0 or 40 + 0 with birthweight 50th percentile (standardized appropriate for gestational age, sAGA) or 3rd percentile (standardized small for gestational age, sSGA). Compared with children born sAGA at gestational week 40 + 0, those born sAGA week 32 + 0 or 35 + 0 had comparable estimated mean height, weight and BMI after 3 years of age. Making the same comparison, those born sSGA week 32 + 0 or 35 + 0 were shorter and lighter with lower estimated mean BMI throughout the whole follow-up period. Our findings suggest that being born SGA and moderate preterm is associated with short stature and low BMI during the first five years of life. The association seemed stronger the shorter gestational age at birth.
Highlights
Being born small for gestational age (SGA) is associated with increased risk of metabolic and cardiovascular complications as well as suboptimal cognitive development later in life1,2. 85–90% of children born SGA show linear catch-up growth during early childhood and will to a large extent reach normal adult stature[3]
Children born SGA, and children born appropriate for gestational age (AGA) but preterm may experience a period of perinatal growth restriction
We hypothesized that SGA and gestational age at birth may interact on postnatal growth patterns in children born moderate preterm
Summary
Being born small for gestational age (SGA) is associated with increased risk of metabolic and cardiovascular complications as well as suboptimal cognitive development later in life1,2. 85–90% of children born SGA show linear catch-up growth during early childhood and will to a large extent reach normal adult stature[3]. With substantial neonatal growth restriction and need of intensive care in the most preterm born infants, potential adverse effects might vary widely within study populations including extreme as well as late preterm births[17]. In this population-based study we had the opportunity to study postnatal growth patterns until five years of age in almost 42,000 children born between gestational week 32 and 40. We hypothesized that SGA and gestational age at birth may interact on postnatal growth patterns in children born moderate preterm. That body proportions at five years may differ depending on size and gestational age at birth
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