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Babies born at extremely low birthweight (ELBW, 2.2 lbs or less) have long been reported to experience "catch-up" growth until as late as 8 years of age. However, a new study of ELBW adolescents (12-18 years of age) reveals that those who survived without a major neurodevelopmental disability nevertheless continued to be smaller in height, weight, and head circumference than peers of normal birthweight (NBW, 5.5 lbs. or more). ELBW adolescents who were both very premature and small for gestational age (SGA) tended to be the smallest.
ELBW adolescents in this study were an average of 4.8 cm shorter (160.5 cm vs. 165.3 cm) and 9.1 kg lighter (55.3 kg vs. 64.4 kg) than NBW adolescents. In fact, far more ELBW than NBW adolescents were below the 25th percentile for height (36 vs. 11 percent) and weight (34 vs. 15 percent). Mean head circumference measurements, which have been shown to be related to cognitive outcomes, also were lower for the ELBW group compared with the NBW group (54.7 cm vs. 56.6 cm), and they were lowest for the ELBW/SGA group. Finally, bone age, measured in SD units, was more advanced in the ELBW group than the NBW group (0.86 vs. 0.42), which may have been due to suboptimal early nutrition—a factor in intrauterine growth retardation affecting SGA infants. Thus, intervention to improve the growth of ELBW children may be appropriate, notes lead author, Myriam Peralta-Carcelen, M.D., M.P.H., of the University of Alabama at Birmingham. The study was supported in part by the Agency for Healthcare Research and Quality as a component of the Patient Outcomes Research Team on Prevention of Low Birthweight in Minority and High-Risk Women (PORT contract 290-92-0055).
The researchers matched 53 ELBW adolescents (including those who were SGA) and 53 NBW adolescents by sex, race, age, and socioeconomic status. They had no major neurodevelopmental disability and were born and cared for in hospitals in one Alabama county. The researchers compared the adolescents height, weight, head circumference, bone age, body composition, and sexual maturity.
See "Growth of adolescents who were born at extremely low birth weight without a major disability," by Dr. Peralta-Carcelen, DeeAnne S. Jackson, M.D., M.P.H., Michael I. Goran, Ph.D., and others, in the May 2000 Journal of Pediatrics 136, pp. 633-640.
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