To describe growth in moderately preterm-born children, determine the prevalence of growth restraint at the age of 4, and identify predictors of growth restraint. We hypothesized that growth in moderately preterm-born children differs from growth in term-born children and that growth restraint is more prevalent in those born prematurely.
This was a community-based cohort study of 1123 children born moderately prematurely (gestational age [GA]: 32–35 weeks) between January 2002 and June 2003.
On average, we found that moderately preterm-born children were shorter and weighed less at each assessment during the first 4 years of life than their term-born counterparts. Thirty-two boys (5.6%) and 18 girls (3.8%) were growth-restricted in height, and 21 boys (3.4%) and 27 girls (5.8%) were growth-restricted in weight. Their growth in head circumference was normal compared with term-born children. In addition, growth restraint was associated with being small for GA at birth (odds ratio [OR] for height: 7.7 [95% confidence interval (CI): 2.9–20.4]; OR for weight: 9.5 [95% CI: 3.9–23.1]) and maternal height below −1 SD (OR for height: 4.9 [95% CI: 2.6–10.2]; OR for weight: 2.6 [95% CI: 1.3–5.2]). Poor head-circumference growth was associated with a low level of maternal education (OR: 5.3 [95% CI: 1.4–20.8]).
Growth in moderately preterm-born children significantly differs from that of term-born children. Predictors at birth are being small for GA, maternal height below −1 SD, and a low level of maternal education. The fact that growth in moderately preterm-born children may lag warrants close monitoring during routine practice. Additional research on prevention of growth restraint is needed.
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