Intrauterine growth restriction (IUGR) is caused by many factors, and most newborns with IUGR are small for gestational age (SGA). SGA infants have a relatively high risk of death and disease in the perinatal period, and the nervous system already has structural changes in the uterus, including the reduction of brain volume and gray matter volume, accompanied by abnormal imaging and pathological changes. IUGR fetuses undergo intrauterine blood flow redistribution to protect brain blood supply, and there are still controversies over the clinical effect of brain protection mechanism. SGA infants have a relatively high risk of abnormal cognitive, motor, language, and behavioral functions in the neonatal period and childhood, and preterm infants tend to have a higher degree of neurological impairment than full-term infants. Early intervention may help to improve the function of the nervous system.
Brain ; Child ; Female ; Fetal Growth Retardation ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Pregnancy

The incidence of perinatal disease and perinatal mortality in small for gestational age infants increased significantly. This group of people is prone to a variety of long-term metabolic diseases and cardiovascular diseases, and is also prone to growth retardation and neurodevelopmental delay, which will seriously affect the long-term quality of life of children. The article studies the neurodevelopmental outcomes of small-for-gestational-age infants. By reviewing and sorting out previous literature, the neurodevelopmental disorders of small-for-gestational-age infants are analyzed according to five aspects: intellectual development, motor development, language development, sensory development, and mental illness. The classification and summary were carried out, and the influencing factors of neurodevelopmental disorders of SGA were also evaluated, so as to provide reference for promoting the improvement of neurodevelopmental outcomes of small-for-gestational-age infants.
Infant, Newborn ; Pregnancy ; Female ; Child ; Infant ; Humans ; Gestational Age ; Quality of Life ; Infant, Small for Gestational Age ; Fetal Growth Retardation/epidemiology*

Objective: To analyze the physical growth of preterm infants with different intrauterine growth patterns. Methods: A total of 10 856 preterm infants who were born in various districts of Haikou City from October 1st, 2015 to June 1st, 2021 and received regular health care and management were retrospectively enrolled. The preterm infants were divided into appropriate for gestational age (AGA), small for gestational age (SGA) and large for gestational age (LGA) groups according to different intrauterine growth patterns. The general characteristics of preterm infants in different groups were compared by H test (Kruskal and Wallis) or Chi-squared test. And the developmental curves were plotted by local regression (LOESS) with their physical growth indexes. Results: Of the 10 856 preterm infants, 6 317 were boys and 4 539 were girls. The gestational age at birth was 35 (34, 36) weeks, and the birth weight was 2.5 (2.1, 2.8) kg. There were 754 (6.9%) SGA, 9 301 (85.7%) AGA, and 801 (7.4%) LGA preterm infants. All preterm infants were followed up until 18 months of corrected age. The birth weight of the SGA group was lower than that of the AGA and LGA groups (Z=2 274.93, P<0.001). The proportion of exclusive breastfeeding at the first health care interview was higher in the AGA group (68.6% (6 378/9 301)) than in the SGA group (62.9% (474/754)) (χ²=13.82, P=0.003). The LOESS curving fitting showed that the weight and height of the preterm infants in all the 3 groups increased rapidly during 0-6 months of corrected age. The regression prediction values of weight for age Z-score (WAZ), height for age Z-score (HAZ) and weight for height Z-score (WHZ) were around 0 s, while the regression prediction values of these three indicators in SGA were all below 0 s but greater than -1 s. The rates of low birth weight, growth retardation and wasting during 0-17 months of corrected age were 0.3% (16/4 838)-1.9% (47/2 506), 0.4% (18/4 838) -2.4% (51/2 124), and 2.1% (88/4 135) -4.4% (214/4 838) in AGA groups, and 0 (0/296) -1.0% (2/199), 0 (0/341) -1.6% (3/186) and 1.0% (2/199) -2.6% (9/341) in LGA group, whereas 7.6% (25/330) -16.8% (28/167), 5.2% (17/330)-10.6%(32/303) and 3.9% (3/77) -12.6% (21/167) in SGA group. In addition, the monthly growth of weight and height of preterm infants in all the 3 groups decreased with the increasing age, and the monthly weight gain. The length increment was 4.0 cm/month during corrected 0-2 month of age and 2.4 cm/month during corrected 2-5 month of age in the SGA preterm infants. Conclusions: Most of the preterm infants could have an appropriate catch-up growth, but the growth and development in the SGA preterm infants lags behind that of their AGA and LGA peers. The physical growth of SGA premature infants should be paid more attention to, to timely correct the growth deviations.
Birth Weight ; Child, Preschool ; Female ; Fetal Growth Retardation ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; Infant, Premature ; Infant, Small for Gestational Age ; Male ; Retrospective Studies

PURPOSE: Study purpose were to describe growth patterns of premature infants in weight, length and head circumference from birth to 40th week of corrected ages (CA) and to explore factors affecting patterns. METHODS: A longitudinal descriptive study was conducted with 267 premature infants. They were categorized into 2 groups; GA group with measurements at birth and the CA group with measurements at CA, which was categorized into 3 groups (group 1-3) by WHO guideline for gestational age (GA) at birth. RESULTS: GA group presented greater measures in all than CA group at same week of life. Among CA groups, group 3 showed the highest measurements, up to 37 weeks of life, though this disappeared at 38-40 weeks. Reversely, group 1 revealed the highest growth rates in all measures, followed by group 2 and group 3. Significant interaction was observed in all measures between week of life and any type of groups. CONCLUSION: Higher measures in GA group, as well group 3 among CA groups, supported the superiority of intra-uterine environment overriding quality of regimen from NICU. Regardless of growth acceleration, smaller infants remain smaller, indicating that intra-uterine thrifty phenotype may continue at least up to the 40th week of CA.
Adult ; Anthropometry ; Birth Weight ; Body Height ; Body Weight ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature/*growth & development ; Infant, Small for Gestational Age/growth & development ; Longitudinal Studies ; Male

OBJECTIVETo observe catch-up growth in height within two years of birth in infants of different sexes, gestational ages, and birth weights with intrauterine growth retardation (IUGR).

METHODSFollow-up was performed on 294 IUGR infants and 300 healthy full-term infants at 4, 6, 9, 12, 15, 18, 21 and 24 months after birth to measure the height, calculate the height increase and compare the two groups with respect to height increase.

RESULTSThe success rates of catch-up growth in height were 72.2% in male infants and 71.5% in female infants (P=0.90), and were 77.4% in preterm small-for-gestational age (SGA) infants and 68.6% in full-term SGA infants (P=0.11). Success rates of catch-up growth in height in infants with birth weights between 1500-2499 g was higher than in those with birth weights of <1500 g and ≥2500 g (P<0.01). The male infants showed significant catch-up growth at 4, 6, 18, 21 and 24 months after birth, while significant catch-up growth was found in female infants at 4, 6, 9, 12 and 21 months after birth. Of the male infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 6 and 9 months after birth. Of the female infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 4 and 18 months after birth. For both male and female infants, height increase at 4 months after birth was significantly greater in those with birth weights of <1500 g than in those with birth weights of ≥2500 g. For male infants, height increases at 4, 6, 18, 21 and 24 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g. For female infants, height increases at 4, 6, 9, 12 and 21 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g.

CONCLUSIONSThe catch-up growth in height within two years of birth in infants with IUGR occurs mainly in the first year after birth in female infants, but can be seen in the first six months and the second year after birth in male infants. Preterm SGA infants better catch-up growth than full-term SGA infants, and infants with birth weights of below 1500 g and between 1500-2499 g show better catch-up growth than those with birth weights of ≥2500 g.

Birth Weight ; Body Height ; Female ; Fetal Growth Retardation ; physiopathology ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Male

PURPOSE: The aim of the study was to investigate postnatal changes in growth and insulin, leptin, IGF-I, adiponectin, and ghrelin, and to examine the relationship of these hormones with catch-up growth in full-term small for gestational age (SGA) infants. METHODS: SGA was defined as a birth weight less than the ten percentile. Weight and height were measured at birth, 1 month, 6 months, 1 year, and 2 years of age in 70 SGA infants (40 females and 30 males). The infants were subdivided according to their weight and height catch-up growth (CUG) at 2 years old. CUG is defined as reaching a standard deviation score (SDS) of > -2 SDS. Blood samples were serially taken for insulin, leptin, insulinlike growth factor (IGF)-I, adiponectin, and ghrelin. RESULTS: 1) Dramatic CUG for weight and height occurred during the first year of life; weight and height growth gain decreased thereafter. 2) Non-catch-up growth (NCUG) infants showed more decreased weight and height growth gain than CUG infants between the first and second year of life. 3) Weight CUG was 77.1% and height CUG was 75.8% in the SGA infants. 4) Weight CUG infants showed significantly higher leptin and ghrelin levels than in weight NCUG infants at the age of 1 year (P <0.05). 5) Height CUG infants showed significantly higher leptin and ghrelin levels than in height NCUG infants at the age of 1 year (P <0.05). CONCLUSION: CUG for weight and height occurred during the first year of life and growth velocity decreased thereafter. Significant corresponding changes occurred with regard to serum leptin and ghrelin.
Adiponectin ; Birth Weight ; Female ; Gestational Age ; Ghrelin ; Humans ; Infant ; Infant, Newborn ; Infant, Small for Gestational Age ; Insulin ; Insulin-Like Growth Factor I ; Leptin ; Parturition

Objective: To analyse the efficacy of recombinant human growth hormone (rhGH) treatment in children born small for gestational age (SGA) with syndormic and non-syndormic short stature. Methods: The clinical data of 59 children born SGA who were diagnosed as short stature and admitted to the Center of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital from July 2012 to June 2021 were collected and analyzed. According to the 2019 consensus on short stature, they were divided into syndromic group and non-syndromic group. Before treatment and 6, 12, 18 and 24 months after treatment, height standard deviation score (Ht-SDS), difference of height standard deviation (∆Ht-SDS) and homeostasis model assessment-insulin resistance index (HOMA-IR) were compared between groups, while Ht-SDS and HOMA-IR were compared before and after treatment. Independent t test or Kruskal-Wallis test were used for comparison between the 2 groups, and paired t test or Mann-Whitney U test were used for the intra-group comparison. Results: Among the 59 cases, 37 were males and 22 females, aged (5.5±2.3) years. There was no significant difference in Ht-SDS after 12 months of treatment between 2 groups (0.9±0.4 vs. 1.2±0.4, t=1.68, P=0.104) or in height SDS after 24 months of treatment (1.4±0.7 vs. 1.9±0.5, t=1.52, P=0.151). After 12 months of treatment, the insulin resistance index of the non-syndromic group was significantly higher than that of the syndromic group (2.29 (1.43, 2.99) vs. 0.90 (0.55, 1.40), Z=-2.95, P=0.003). There were significant differences in Ht-SDS between 6 months and before treatment, 12 months and 6 months in syndromic type (Z=7.65, 2.83 P<0.001, P=0.020), but all were significant differences in non-syndromic type between 6 months and before treatment, 12 months and 6 months, 18 months and 12 months, 24 months and 18 months (Z=11.95, 7.54, 4.26, 3.83, all P<0.001). Conclusion: The efficacy of rhGH treatment in children born SGA is comparable between syndromic and non-syndromic short stature cases, but non-syndromic children treated with rhGH need more frequent follow-up due to the risk of insulin resistance.
Child ; Female ; Humans ; Male ; Body Height ; Gestational Age ; Human Growth Hormone/therapeutic use* ; Infant, Small for Gestational Age ; Insulin ; Insulin Resistance ; Recombinant Proteins ; Child, Preschool

OBJECTIVETo investigate the physical growth and psychomotor development of very low birth weight (VLBW) preterm infants in the first year after birth and related influencing factors.

METHODSA total of 61 VLBW preterm infants received growth and development monitoring for 12 months. Z score was used to evaluate parameters for physical growth, and Denver Development Screen Test (DDST) was used for development screening.

RESULTSAmong the 61 VLBW preterm infants, 27 (44.3%) were small-for-gestational-age (SGA) infants, and 34 (55.7%) were appropriate-for-gestational-age (AGA) infants. During the 1-year follow-up, the median weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), head circumference-for-age Z-score (HCZ), and weight-for-height Z score (WHZ) were >-1 SD in all age groups. The peaks of body mass index-for-age Z-score (BAZ) and WHZ appeared at 1 month of corrected age. At a corrected age of 40 weeks, the incidence rates of underweight, growth retardation, emaciation, microcephalus, overweight, and obesity were 15%, 16%, 11%, 13%, 20%, and 10%, respectively. Compared with those with a corrected age of 40 weeks, the infants with a corrected age of 6 months or 9-12 months had a significantly reduced incidence rate of overweight (3%) (P<0.05). Up to 1 year after birth, 15 infants (25%) had abnormal developmental quotient (DQ). The SGA group had a significantly higher incidence rate of abnormal DQ than the AGA group (P<0.05). SGA was the independent risk factor for retarded growth in the first year after birth in VLBW preterm infants.

CONCLUSIONSVLBW preterm infants experience an obvious growth deviation within 3 months of corrected age. Within the first year after birth, the proportion of infants with abnormal DQ screened by DDST is high.

Body Weight ; Child Development ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Infant, Very Low Birth Weight ; growth & development ; Male

OBJECTIVETo study serum gastrin levels in response to early minimal feeding in premature infants and evaluate the clinical effect of early minimal feeding.

METHODSPremature infants with critical score < or = 90 were randomly assigned into two groups: early minimal feeding group (n = 48), non-early minimal feeding group (n = 47). Other premature infants (n = 30) without any complications (critical score > 90) were assigned as normal control group. The premature infants in normal control group were fed with water at 6 h after birth, 1 - 2 ml/kg every time, after once or twice, they were fed with formula, increasing in the amount of formula gradually, until adequate. The premature infants in early minimal feeding group were fed with formula within 72 h after birth, 0.5 - 1 ml/kg, once every 3 h, the amount of formula was increased gradually, until adequate. The premature infants without early minimal feeding were not fed with formula until the illness was stable, the amount of formula was increased gradually until adequate. Situation of gastrointestinal feeding tolerance, growth and development, and clinical symptoms were observed and recorded for the three groups. Serum gastrin levels were monitored at 1, 3, 7 day after birth by radioimmunoassay.

RESULTSSerum gastrin concentrations in the three groups elevated from 1 to 7 days. In early minimal feeding group [(82.4 +/- 24.5) ng/L] and non-early minimal feeding group [(87.0 +/- 40.2) ng/L], the concentrations were significantly higher than those in normal control group [(66.4 +/- 19.7) ng/L] at day 1 (F = 3.36, P < 0.05). At day 3 and 7, the concentrations in early minimal feeding group [(96.3 +/- 14.6) ng/L, (113.0 +/- 16.5) ng/L] were significantly higher than those in non-early minimal feeding group [(73.9 +/- 13.5) ng/L, (92.4 +/- 12.2) ng/L] (P < 0.05). There were significant differences among the three groups in infants with feeding intolerance (2/30, 5/48, 14/47), the period reached full enteral feeding [(20.6 +/- 5.7) d, (27.8 +/- 6.1) d, (39.5 +/- 4.7) d], and in number of hospital day [(29.0 +/- 4.6) d, (39.0 +/- 4.8) d, (48.0 +/- 5.6) d] (P < 0.05). There were significant differences between early minimal feeding group and non-early minimal feeding group in the weight gain three and four weeks after birth [(19.1 +/- 2.4) g/d, (11.9 +/- 3.3) g/d], the period reached birthweight [(19.8 +/- 4.2) d, (25.2 +/- 5.1) d] (P < 0.05). There were no significant difference among the three groups in the weight gain in one and two weeks after birth [(5.9 +/- 2.9) g/d vs. (5.0 +/- 2.1) g/d], the numbers of premature infants with infection, anemia, apnea, or hypoglycemia.

CONCLUSIONEarly minimal feeding in premature infants leads to secretion of gastrin, promotes the development of gastrointestine and may not be associated with occurrence of complications.

Birth Weight ; Enteral Nutrition ; methods ; Female ; Gastrins ; blood ; Gastrointestinal Tract ; growth & development ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Premature ; blood ; Infant, Small for Gestational Age ; Male

OBJECTIVETo investigate the correlative factors of weight gain in very low birth weight infants (VLBW).

METHODSFifty-one cases of VLBW from July 1998 to March 2004 were analyzed retrospectively.

RESULTSTwenty two cases were small for gestational age (SGA) and 29 cases were appropriate for gestational age (AGA). The age of first feeding was (2.35 +/- 2.29) d. Caloric intake was (377.61 +/- 121.50) kJ/(kg.d) [(90.25 +/- 29.04) kcal/(kg.d)] and protein intake was (2.18 +/- 0.83) g/(kg.d). The age of birth weight regained was (7.41 +/- 3.57) d and the velocity of weight gain was (16.38 +/- 9.29) g/d or (12.63 +/- 7.15) g/(kg.d). Single factor analysis found that early feeding and caloric supply and protein supply had significant influence on weight gain (P < 0.05). The result of multivariate linear analysis showed that the significant risk factors were associated with supply of calorie and protein. The equation was Y (weight gain) = -6.426 + 0.120X(1) (caloric supply) + 3.737X(2) (protein supply) (P < 0.01). The caloric supply of the cases that achieved the nutritional goal was (468.19 +/- 67.11) kJ/(kg.d), [(111.90 +/- 16.04) kcal/(kg.d)], and that with enteral nutrition and partial parenteral nutrition was [(520.62 +/- 21.59) kJ/(kg.d)], [(124.43 +/- 5.16) kcal/(kg.d), (451.49 +/- 68.41) kJ/(kg.d)], [(107.98 +/- 16.35) kcal/(kg.d)] respectively. There was significant difference between the two groups (P < 0.05). The mean rank of time of birth weight regaining, the time in hospital stay and duration of parenteral nutrition providing at least 75% of the total daily fluid volume was 18.58, 20.24 and 20.11 in the group of early feeding, and it was 33.00, 32.48 and 31.83 in the group of late feeding, respectively. There were significant differences between the two groups (P < 0.05).

CONCLUSIONSufficient supply of calorie and protein should be ensured in VLBW infants, especially in SGA and severely ill infants. It was very important to feed VLBW infants as early as possible, which could improve feeding tolerance and gastrointestinal maturation. VLBW infants should receive parenteral nutrition as supplements to enteral feeding.

Enteral Nutrition ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Infant, Very Low Birth Weight ; growth & development ; Multivariate Analysis ; Parenteral Nutrition ; Retrospective Studies ; Risk Factors ; Weight Gain