HEAD GROWTH IN SICK PREMATURE INFANTS-A LONGITUDINAL STUDY

Abstract

Serial weekly measurements of somatic growth and head circumference were made for 10 weeka on 45 Caucasian infants. They had major neonatal problems - 32 (71%) required prolonged assisted ventilation. All were AGA, gestations ranged from 26-32 weeks (M 30.4±1.6 wks) and caloric intake from 102-130 cals/kg/day by the end of the 2nd week. During the first 7 weeks, coincident with their illness, the velocity of growth was significantly below that of the normal fetus with deviation away from and below the fetal growth curve. For head circumference, velocity was 0.2 cm/wk vs. 0.9 cm/wk for normal fetal growth (p<.05). During recovery over the next 3 weeks growth paralleled that of healthy preterm infants. Subsequently rapid “catch-up” growth in head circumference occurred. By comparison, 6 similar infants whose head circumference followed the intra-uterine growth curve had proven hydrocephalus. These results suggest that: (1) Growth in the sick preterm infant does not proceed at the same velocity as in the fetus and the use of growth charts based on cross-sectional fetal growth may be misleading; (2) Hydrocephalus should be suspected in a sick infant whoae head circumference follows the fetal growth curve; (3) In spite of an adequate caloric intake, the energy distribution of the sick LBW Infant appears to prevent new growth until the acute illness has resolved.