CHAPTER 5 Similar growth in preterm infants with intra- or extrauterine growth restriction

Objective: To analyse the influence of preterm growth restraint (PGR) in pre-term infants born appropriate-for-gestational-age (AGA) on growth achieve-ment at 2 years of age and to compare their growth with preterm small-for-ges-tational-age (SGA) infants. Design: Regional, prospective study of infants born < 32 weeks gestational age (GA). Length, weight and head circumference were measured at term, 1 and 2 years of age and expressed as Standard Deviation Scores (SDS). PGR was defined as length and/or weight at term age <-1.3 SD. Results: Of the 158 infants, 23 (14%) infants were SGA, 61 (39%) were AGA-PGR and 74 (47%) AGA-nonPGR. At all ages the SGA-infants had the lowest length, weight and head size. At 2 years of age AGA-PGR-infants had a similar mean length as SGA-infants (-0.68 vs.-0.80 SDS), a lightly bigger head cir-cumference (-0.09 vs.-0.40 SDS) and a higher weight (-0.93 vs.-1.50 SDS) and weight-for-length (-0.79 vs.-1.51 SDS). The AGA-nonPGR-infants dis-played growth parameters comparable to the Dutch reference group, except for a relatively large head circumference (0.38 SDS). After correction for confounders PGR remained the most important predictor for sub-optimal growth at 2 years in the AGA-infants. Conclusion: Preterm infants, who experience preterm growth restraint, are at increased risk for sub-optimal growth at the corrected age of 2 years. Their growth is similar to that of SGA-infants concerning length and head circumfer-ence. Similar growth in preterm infants with intra- or extrauterine growth restriction 7