Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 28;16(1):e0245387.
doi: 10.1371/journal.pone.0245387. eCollection 2021.

Perinatal determinants of growth trajectories in children born preterm

Elizabeth A Jasper  1 , Hyunkeun Cho  2 , Patrick J Breheny  2 , Wei Bao  1 , John M Dagle  3 , Kelli K Ryckman  1
Affiliations

Perinatal determinants of growth trajectories in children born preterm

Elizabeth A Jasper et al. PLoS One. .

Abstract

Background: A growing amount of evidence indicates in utero and early life growth has profound, long-term consequences for an individual's health throughout the life course; however, there is limited data in preterm infants, a vulnerable population at risk for growth abnormalities.

Objective: To address the gap in knowledge concerning early growth and its determinants in preterm infants.

Methods: A retrospective cohort study was performed using a population of preterm (< 37 weeks gestation) infants obtained from an electronic medical record database. Weight z-scores were acquired from discharge until roughly two years corrected age. Linear mixed effects modeling, with random slopes and intercepts, was employed to estimate growth trajectories.

Results: Thirteen variables, including maternal race, hypertension during pregnancy, preeclampsia, first trimester body mass index, multiple status, gestational age, birth weight, birth length, head circumference, year of birth, length of birth hospitalization stay, total parenteral nutrition, and dextrose treatment, were significantly associated with growth rates of preterm infants in univariate analyses. A small percentage (1.32% - 2.07%) of the variation in the growth of preterm infants can be explained in a joint model of these perinatal factors. In extremely preterm infants, additional variation in growth trajectories can be explained by conditions whose risk differs by degree of prematurity. Specifically, infants with periventricular leukomalacia or retinopathy of prematurity experienced decelerated rates of growth compared to infants without such conditions.

Conclusions: Factors found to influence growth over time in children born at term also affect growth of preterm infants. The strength of association and the magnitude of the effect varied by gestational age, revealing that significant heterogeneity in growth and its determinants exists within the preterm population.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study population.
See this image and copyright information in PMC

References

    1. Barker DJ. The fetal and infant origins of adult disease. BMJ (Clinical research ed). 1990;301(6761):1111 10.1136/bmj.301.6761.1111 - DOI - PMC - PubMed
    1. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(3 Pt 2):518–25. . - PubMed
    1. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. 2007;150(1):12–7 e2. 10.1016/j.jpeds.2006.08.042 . - DOI - PubMed
    1. Lloyd LJ, Langley-Evans SC, McMullen S. Childhood obesity and risk of the adult metabolic syndrome: a systematic review. International journal of obesity (2005). 2012;36(1):1–11. 10.1038/ijo.2011.186 - DOI - PMC - PubMed
    1. Barker DJ, Osmond C, Forsen TJ, Kajantie E, Eriksson JG. Trajectories of growth among children who have coronary events as adults. The New England journal of medicine. 2005;353(17):1802–9. Epub 2005/10/28. 10.1056/NEJMoa044160 . - DOI - PubMed

Publication types