Growth In Small For Gestational Age Infants Research Articles

Extreme Premature Small for Gestational Age Infants Have Appropriate Catch-up Growth at Term Equivalence Compared with Extreme Premature Appropriate for Gestational Age Infants

Recent studies have shown that small for gestational age (SGA) term infants undergo catch-up growth during infancy but there is limited studies on early growth outcomes of extreme premature SGA infants. The aim of this study was to compare factors associated during birth in extremely premature infants less than 28 weeks’ gestation who were born SGA (<10th percentile for gestational age) with those who were born appropriate-for-gestational age (AGA) (10th-89th percentile) and to determine whether there was catch-up growth at term equivalence. One hundred fifty-three extreme premature infants (89 males) born below 28 weeks’ gestation were prospectively recruited. All infants had auxological measurements undertaken and prospective data on pregnancy, maternal factors, perinatal and postnatal data obtained. SGA infants at birth had significantly higher Clinical Risk Index for Babies scores and mortality, lower birth weight, smaller head circumference, smaller mid arm circumference and shorter leg length at time of birth compared with AGA infants. However, at term equivalence, weight and leg length of were not significant between AGA and SGA infants born at extreme prematurity. Our study shows that extreme premature SGA infants have appropriate catch-up growth by the time they reach term equivalence suggesting that postnatal nutrition and care are important determinants of catch-up growth in SGA infants.

364 Body Composition in Small for Gestational and Large for Gestational Age Infants at One Week and 12 Weeks of Age

Background: Full term infants born small for gestational age (SGA) or large for gestational age (LGA) are at an increased risk for metabolic complication. Improved nutrition with catch-up growth has been related to insulin resistant and metabolic syndrome leading to the concern that “bigger might not be better”. Aims: To use Pea Pad, a device based on air displacement plethysomgraphy, to compare body composition in full-term infants born SGA and LGA. Methods: Body composition was assessed in 20 infants born SGA and in 20 infants born LGA in the first week of life and at 12 weeks. Results: At one week SGA infants contained 3,9 (± 2,0) % body fat and LGA infants contained 16,3 (± 5,2) % body fat. At 12 weeks SGA infants body weight were 6071 (± 675) g and contained 26 (± 4,1) % body fat. LGA infants body weight were 7205 (±792) g and contained 27,3 (± 5,0) % body fat. There was a significant difference in body weight, but no significant difference in % body fat (p= 0,59) between the groups at 12 weeks. The regression line between body fat (dependent variable) and body weight was for SGA infants at 12 weeks y=4,46 + 0,04 x, r=0,58, p=0,003 and for LGA infants y=20,9 + 0,001 x, r=0,14, p=0,6. Conclusions: The catch up growth in SGA infants consist of “catch up fat” compared to LGA infants. It seems that LGA infants sustained a metabolic capacity and SGA developed a metabolic load at 12 weeks.

No Weight Catch-Up Growth of SGA Infants Is Associated with Impaired Insulin Sensitivity during the Early Postnatal Period

Objective. To investigate the relationship between weight catch-up growth and insulin sensitivity in small for gestational age (SGA) infants. Methods. Forty-four singleton SGA subjects met the inclusion criteria and finished-3-month followup. Body weight, length, fasting glucose, and fasting insulin (FI) levels were measured at 3 days and 3 months. Insulin sensitivity was evaluated by FI and homeostasis model assessment (HOMA). Results. According to the change of weight Z-score, forty-four subjects were divided into two groups: noncatch-up growth (NCUG) and catch-up growth (CUG). By 3 months of age, the body weight, body length and BMI of NCUG group were significantly lower than those of CUG group. The FI and HOMA were significantly higher in NCUG group. The change of weight Z-score during 3 months was inversely related to the HOMA at 3 months. Conclusion. Our data exemplified that no weight catch-up growth during the first 3 months was associated with impaired insulin sensitivity in SGA infants.

Low birth weight and early weight gain in the metabolic syndrome: Consequences for infant nutrition

Emerging data indicate that being born small for gestational age (SGA) and rapid infant catch-up growth may play a significant role in the risk of developing type 2 diabetes (T2DM) and the metabolic syndrome (MS) many years later in life. The impact of these perinatal T2DM and MS risk factors may be more important than genetics in some parts of the world, including low-income countries. Breastfeeding for 3–6 months is associated with reduced risk of developing insulin resistance and the metabolic syndrome. Promotion of fast growth in SGA infants by nutrient-enriched formula increases risk of hypertension and the metabolic syndrome. While waiting for better knowledge of how to combat T2DM and MS with early-life interventions, breastfeeding should be recommended and enforced whenever possible, keeping in mind the health and nutritional status of the mother. Furthermore, promotion of fast weight gain in SGA infants by nutrient-enriched formula feeding should be used with caution. However, growth limitation by restriction of nutrition in SGA infants below general recommendations should not be recommended.

Kidney growth in small-for-gestational-age infants: evidence of early accelerated renal growth

Very few data are available on longitudinal renal growth in small for gestational age (SGA) infants born at term. The aim of this prospective study was to estimate comparatively the renal growth in SGA infants and in infants born appropriate for gestational age (AGA) during the first 2 years of life. The study comprised groups of SGA and AGA infants with a gestational age (GA) of 36-41 weeks. The SGA group was classified into two subgroups of symmetrical and asymmetrical neonates according to the ponderal index. Serial renal ultrasonography (US) was performed at the ages of 41 weeks corrected age [GA (in weeks) plus age after birth (in weeks)] and at 3, 6, 12 and 24 months of chronological age and kidney length (KL) was related to other anthropometric indices. A total of 312 infants participated in the study out of which 197 were SGA, and a total number of 802 measurements were performed. The symmetrical SGA infants and, to a lesser degree, the asymmetrical SGA infants had smaller kidneys at birth compared with the AGA infants (P < 0.0001 and P < 0.001, respectively). The symmetrical SGA infants had a lower body weight (BW) (P < 0.001, P < 0.01) and crown-heel length (CHL) (P < 0.01, P < 0.05) than controls at the ages of 12 and 24 months of chronological age. The asymmetrical SGA infants had a lower BW (P < 0.01, P < 0.05) than controls at the ages of 12 and 24 months of chronological age. On the contrary, the KL in both SGA groups was not different from that of the AGA infants after the 41st week of corrected age and up to the 2nd year of life. SGA term infants had shorter KL at birth compared with AGA infants but a similar length from the 3rd to the 24th month of life. Early catch-up kidney growth was observed in both SGA groups and is more prominent in the symmetrical SGA infants. This observation may represent either an accelerated renal maturation process or early compensatory kidney hypertrophy in this group of infants.

Faecal chymotrypsin in small for gestational age infants: effects of nucleotides and breast feeding

The effect of diet on pancreatic exocrine function, measured by faecal chymotrypsin activity (FCA), was studied longitudinally in three groups of small for gestational age (SGA) infants in the first...

Nucleotide supplementation and the growth of term small for gestational age infants.

A double blind randomised controlled trial in small for gestational age (SGA) infants, whose intestinal mucosa was shown to be functionally impaired as a result of intrauterine undernutrition, was carried out to investigate the hypothesis that nucleotide supplementation of a milk formula could improve catchup growth. Anthropometric data were collected on 74 infants, 39 randomly allocated to the nucleotide supplemented group (group N) and 35 to a standard formula group (group S). From study entry to 2 months of age, infants in group N had significantly higher mean rates of weight gain (106.3 compared with 94.7 g/kg baseline weight/week) and length gain (21.8 v 19.7 mm/m baseline length/week). Over the whole six months for which the trial formula was provided group N had significantly higher mean rates of gain of weight (80.1 compared with 71.8 g/kg baseline weight/week), length (16.2 compared with 15.0 mm/m baseline length/week), and head circumference (11.8 compared with 10.8 mm/m baseline head circumference/week). Catchup growth in SGA infants is therefore improved by nucleotide supplementation of infant formula.