Citation

Pierrat V, Marchand-Martin L, Guemas I, Matis J, Burguet A, Picaud JC, Fresson J, Alberge C, Marret S, Roze JC, Kamiński M, Larroque B, Ancel PY. Arch. Dis. Child. Fetal Neonatal Ed. 2011; 96(5): F348-54.

Affiliation

Neonatal Unit, University Teaching Hospital, Hôpital Jeanne de Flandre, Lille Cedex, France. vpierrat@chru-lille.fr

Copyright

(Copyright © 2011, BMJ Publishing Group)

DOI

10.1136/adc.2010.185470

PMID

21242241

Abstract

OBJECTIVES: To evaluate growth for children born very preterm with particular focus on those born small-for-gestational age (SGA) or with ex utero growth restraint (GR), and to identify risk factors for short stature at 5 years of age. STUDY DESIGN: Population-based study of children born at less than 33 completed weeks of gestation (Étude Epidémiologique sur les Petits Ages Gestationnels (EPIPAGE)). Short stature was defined as height <-2SD on WHO growth curves. Ex utero GR was considered to have occurred in children with appropriate size for gestational age at birth and with a height and/or weight below -2SD at 2 years of corrected age. Logistic regression models were used to test associations between risk factors and short stature.

RESULTS: The authors measured height at 5 years of age for 1,597 of 2,193 children (73%), 5.6% (95% CI 4.6 to 6.9) of whom were diagnosed as having a short stature. Height was measured at 2 and 5 years of age in 1417 children. Among these, 24% of those born SGA and 36% of those with ex utero GR (p=0.002) had a short stature at 5 years. Predictors of short stature were SGA or birth length <-2SD, maternal height ≤ 160 cm, gestational age <29 weeks and systemic corticosteroids. Breastfeeding at discharge decreased the risk of short stature.

CONCLUSIONS: Short stature at 5 years of age is common in children born preterm. The highest incidence was observed in the group with ex utero GR. Systemic steroids have a long-term impact on growth and should be used with caution. Breastfeeding at discharge appeared to be protective.

Language: en