Catch Up Head Growth

Catch-up growth of head circumference of very low birth weight, small for gestational age preterm infants and mental development to adulthood. Brandt I, Sticker EJ, and Lentze MJ. J Pediatr (May 2003);142:463-8.

Objective: To examine the influence of postnatal energy quotient (EQ, energy intake/kg body weight per day) on head circumference (HC) growth and mental development of very low birth weight (VLBW), small for gestational age (SGA, <10th percentile) preterm infants.

Study design: SGA VLBW preterm infants (n = 46) with primarily symmetric intrauterine growth restriction were compared with 62 appropriate for gestational age (AGA) VLBW preterm infants and 73 term infants from the Bonn Longitudinal study.

Results: Twenty-seven of 46 (59%) of the SGA preterm infants showed complete HC catch-up growth by the age of 12 months, but mostly before 6 months after term (HC catch-up group). These infants had significantly higher mean EQs from day 2 to 10 than the group of 19 infants without HC catch-up (EQ, 95 vs 78). Mean EQs correlated significantly with developmental and intelligence quotients (DQ/IQ) from 18 months to 6 years. As adults, the HC of the HC catch-up group was not significantly different from that of the AGA preterm infants, the term infants, and their parents. The group without HC catch-up had smaller HC as adults.

Conclusions: Our data suggest that early postnatal high-energy nutrient intake for SGA preterm infants is needed to promote HC catch-up growth and to prevent negative consequences of undernutrition.

Comments: It appears that good nutritional support during the first 1-2 weeks of life is necessary for optimal brain growth and function in SGA VLBW infants. If we starve these infants during this critical period, it is likely that they will not catch up later. ABK

Date: 15 Oct 2004
Time: 12:39:45

needs a study comparing protein supplementation and control group. The reason is because proteins are the one macronutrient that are frequently overlooked in the initial periods. Comparison should also include asymmetric SGA as a separate limb.

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