EFFECTS OF INTRAUTERINE GROWTH-RETARDATION IN PREMATURE-INFANTS ON EARLY-CHILDHOOD GROWTH

Objective: To evaluate in preterm infants the role of intrauterine gro wth retardation and infant body proportionality on subsequent childhoo d growth. Methods: Preterm infants (818) prospectively enrolled in the Infant Health and Development Program were studied from birth to 36 m onths of corrected age. Weights and lengths were recorded at eight int ervals. Growth parameters were compared in preterm infants with differ ing body symmetry at birth, defined by length-for-age and weight-for-a ge. Infants with both low length-for-age and low weight-for-age at bir th were categorized as symmetrically growth retarded, and infants with normal length-for-age and low weight-for-age were categorized as asym metrically growth retarded. Results: Infants born with low length-for- age demonstrated increased growth velocity until 8 months of corrected age (p<0.001). However, infants born with low weight-for-age demonstr ated decreased weight-gain velocity compared with preterm infants with appropriate weight for gestational age (AGA) until 40 weeks of correc ted age (p<0.001). Heights and weights of infants with either symmetri c or asymmetric intrauterine growth retardation remained significantly retarded compared with AGA preterm patients and the National Child He alth Survey (NCHS) reference population (p<0.001). Infants born short but with normal weight did not significantly differ from AGA preterm i nfants in either weight or length at 36 months of corrected age. Prete rm infants with both symmetric and asymmetric growth retardation demon strated limited catch-up growth in weight until age 4 months and then paralleled the AGA preterm patients and the NCHS reference population. Very low birth weight (less than or equal to 1250 gm), gestational ag e, and a broad-based day-care intervention did not influence growth ou tcome after control for the presence of intrauterine growth retardatio n. Conclusions: Preterm infants with both symmetric and asymmetric int rauterine growth retardation demonstrate limited catch-up growth. Intr auterine growth deficits persist into early childhood.