Normal growth outcome in ELBW (≤1kg) infants is considered an indicator of good long term prognosis for health and development. Poor growth in ELBW infants is associated with neonatal illness, and poor neurodevelopmental and psychosocial status. We hypothesized that the incidence and severity of growth failure increases with decreasing BW and GA due to severity of complications of ELBW. In this multicenter study 1151 (78%) of 1527 infants surviving to discharge were evaluated at 18+4 months corrected age; 915 (82%) were appropriate for gestation (AGA) and 204 (18%) were small for gestation(SGA)(Alexander, Obstet Gynecol, 1996). Anthropomorphic measures were obtained using standard techniques. Measures at birth were compared to 36 week weight(Wt), 18 month weight, length (L), head circumference (HC), and weight-to-height ratio (Wt/Ht): Table Median weight, length, and head circumference were lower than standard NCHS data in all BW groups stratified in 100g intervals. Poor growth, ≤10%ile, was seen in all measures at all time points, particularly at 36 weeks, and was inversely related to BW. Failure-to-thrive (FTT) defined as a weight-to-height ratio≤10%ile, was greater in the SGA group vs. AGA group (51% vs 31%, p=0.001). FTT at 18 months was associated with lower BW, SGA, white race, abnormal neurologic diagnosis, and abnormal swallow on logistic regression analysis. These data show a high incidence of poor growth at 18 months in the ELBW infant; we speculate that assessment and aggressive management of health, nutrition, and developmental correlates of growth may improve outcome.

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