Catch-up growth during childhood among very low-birth-weight children

Objectives: To examine growth attainment and correlates of catch-up growth at 8 years of age in a cohort of very low-birth-weight (VLBW) children (<1500 g), including appropriate and small-for-gestational-age children, and to compare their growth with normal-birthweight (NEW) children. Design: Eight-year longitudinal follow-up of a cohort of VLBW children. A geographically based, randomly selected sample of NEW children was recruited at 8 years of age. Setting: Tertiary perinatal center. Participants: Two hundred forty-nine VLBW children born between January 1, 1977, and December 31, 1979 (78% of survivors), of whom 199 were born appropriate for gestational age and 50 were small for gestational age (<-2 SD). The NEW population included 363 children. Main Outcome Measures: For the VLBW population, rates of subnormal weight (below the third percentile) and height were obtained at birth, at 40 weeks (term), and at 8 and 20 months. For the VLBW and NEW populations, mean weight, height, and percentile distribution at 8 years were derived from the National Center for Health Statistics standards. Results: Catch-up growth to above the third percentile occurred between 40 weeks and 8 months, 8 and 20 months, and up to 8 years of age among the VLBW children. At 40 weeks, 54% were subnormal in weight and 60% were subnormal in height; at 8 months, 33% and 22%, respectively, and at 8 years, 8% were subnormal in weight and height. Small-for-gestational-age children had lower rates of catch-up growth. Multivariate analyses disclosed maternal height, race, birth weight, and neurologic abnormality to predict percentile distribution of height; and maternal height, small for gestational age, and neurologic abnormality to predict subnormal height. Conclusions: Catch-up growth occurs during childhood among VLBW children. These results have implications when counseling parents about the potential growth attainment of their children.