Growth and development of term children born with low birth weight: Effects of genetic and environmental factors

doi:10.1016/S0022-3476(98)70180-5

The Journal of Pediatrics

Volume 133, Issue 1, July 1998, Pages 67-72

https://doi.org/10.1016/S0022-3476(98)70180-5 Get rights and content

Abstract

Objective: To evaluate the role of intrauterine growth retardation (IUGR) on childhood growth and development, controlling for environmental and genetic factors.

Methods: Women and infants enrolled in the National Collaborative Perinatal Project were analyzed. Weight, length, and IQ were assessed at birth and at 7 years in the entire National Collaborative Perinatal Project population in term infants born with and without IUGR (“population cohort”). To control for genetic and environmental factors, growth and development were also compared in 220 similar-sex term sibling pairs in which one sibling was born with IUGR and one was born without IUGR (“sibling cohort”).

Results: At 7 years of age heights and weights of infants born with IUGR remained ~0.5 SD less than infants born without IUGR (weight-for-age: p < 0.001, height-for-age: p < 0.001). In the entire National Collaborative Perinatal Project population, IQ (p < 0.001) and Bender-Gestalt (p < 0.001) scores were significantly lower in infants born with IUGR compared with those in infants born without IUGR. There were no significant differences in IQ or Bender-Gestalt scores between siblings born with and without IUGR. However, siblings with IUGR and large deficits in head circumference demonstrated both decreased IQ (p < 0.05) and Bender-Gestalt (p < 0.05) scores.

Conclusion: Long-term growth deficits associated with IUGR appear largely independent of prenatal or postnatal environmental factors. IUGR had little impact on intelligence and motor development except when associated with large deficits in head circumference. (J Pediatr 1998;133:67-72)

Section snippets

Sample

The NCPP prospectively monitored 59,393 women enrolled during their pregnancy and their 55,760 children from 1959 to 1976. A total of 8411 women were enrolled for at least two different pregnancies. Pregnancy complications were elicited at the time of registration and throughout pregnancy. Gestational age was measured by dating the last menstrual period at the time of registration. Prepregnancy weight was determined by maternal recall at the time of registration. Infants were excluded if they

Maternal Characteristics (Table I)

In the population cohort mothers of infants born with IUGR were significantly lighter (p < 0.001) and shorter (p < 0.001) than mothers of infants with normal birth weight. In both cohorts significantly lower pregnancy weight gain occurred in mothers of infants with IUGR (population cohort: p < 0.001, sibling cohort: p < 0.05). Because mothers in the sibling cohort all had at least one child with IUGR, it is not surprising that they were also shorter and lighter than the general population

Discussion

Infants with birth weights <2500 gm remained significantly lighter and shorter compared with nongrowth-retarded infants. The mean WAZ and HAZ of infants with low birth weight at 7 years of age were approximately 0.5 SD less than those of infants with normal birth weight. These differences correspond to an average height deficit of 2 cm and a weight deficit of approximately 1.6 kg at 7 years of age. Because mothers of infants born with IUGR are both shorter and lighter than mothers who do not

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^☆: From the Division of Pediatric Gastroenterology and Nutrition, UMDNJ - Robert Wood Johnson School of Medicine, New Brunswick, New Jersey; the Division of Pediatric Gastroenterology and Nutrition, The Floating Hospital for Children at New England Medical Center and Tufts University School of Medicine, Boston, Massachusetts.

^☆☆: Supported by grants T 29 DK 07471 and P30 DK 46200 from the National Institutes of Health and the Massachusetts Department of Public Health.

^★: Reprint requests: Richard S. Strauss, MD, Division of Pediatric Gastroenterology & Nutrition, UMDMJ - Robert Wood Johnson Medical School, One Robert Wood Johnson Pl., New Brunswick, NJ 08903.

^★★: 0022-3476/98/$5.00 + 0 9/21/89923

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Growth and development of term children born with low birth weight: Effects of genetic and environmental factors☆,☆☆,★,★★

Abstract

Section snippets

Sample

Maternal Characteristics (Table I)

Discussion

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Clin Nutr

J Nutr

Early Hum Devel

Nutritional status of light-for-dates infants at birth and it influence on early postnatal growth

Arch Dis Child

Postnatal somatic growth in infants with atypical fetal growth patterns

Am J Dis Child

Growth and development of full-term nonasphyxiated small-for-gestational-age newborns: follow-up through adolescence

Pediatrics

Are children born small for gestational age at increased risk for short stature?

Am J Dis Child

Delayed growth and reduced intelligence in 9-17 year old intrauterine growth retarted children compared with their monozygous co-twins

Acta Paediatr Scand

Growth and development of twins of dissimilar size at birth

N Engl J Med

Heterogeneous growth and mental development of intrauterine growth-retarded infants during the first 3 years of life

Pediatrics

Growth and development of nonasphyxiated smallfor-gestational-age newborns: follow-up through adolescence

Pediatrics

Abilities of children who were small-for-gestational-age babies

Pediatrics

Determinants of low birth weight: methodological assessment and meta-analysis

Bull Who

The ponderal index as a measure of the nutritional status at birth and its relationship to some aspects of neonatal morbidity

J Perinat Med

Diagnosis of impaired fetal growth in newborn infants

Pediatrics

Use and abuse of Apgar score

Pediatrics

The first year of life

The women and their pregnancies: The Collaborative Perinatal Study of the NINDS