Abstract
Purpose: To compare the growth and neurodevelopment from birth to age 16 yrs of premature (PRE), small-for-gestational-age (SGA), and normal-birth-weight (NBW) infants born and raised in China.
Methods: Prospective cohort study of 203 low-birth-weight (LBW, <2500 g) and 71 NBW (>2500 g) infants who were born at 2 Shanghai hospitals in 1983 and matched for birth date, gender, and parental occupation. Infants<1,200 g were excluded from the study due to their low likelihood of survival. SGA (n=101) was defined as LBW<10th percentile for gestational age37 wks and PRE as gestational age<37 wks. Primary outcome variables were Wt, Ht, body mass index (BMI), head circumference (HC), Wechsler intelligence quotient (IQ), and scholastic achievement test scores (SATs) at age 16 yrs. Secondary outcomes were the tempo of Ht, Wt, and HC growth; and childhood neurodevelopment assessed by the Gesell developmental quotient (DQ). Subjects were seen monthly to age 1 yr, every 6 mos to 3 yrs, yearly to 6 yrs, and once at 16 yrs. Generalized estimating equations (GEE) with adjustment for gender were used to compare the groups for outcomes and tempo of growth over time. Standardized Z scores for mean outcomes in the SGA and PRE groups were plotted against age to display size, development, and catch-up relative to the NBW group.
Results: Of the 274 enrolled subjects, 234 (85%) returned at 6 mos, 135 (49%) at 6 yrs, and 104 (38%) at 16 yrs. There were NS differences between SGA, PRE, and NBW enrollees in baseline characteristics or rates of follow-up. Wt at each visit through 6 yrs (P<0.02) and ht and HC through 16 yrs (P<0.001) were lower in SGA and PRE than NBW subjects. There were NS differences in BMI at 16 yrs or in wt or ht change over time, but HC change was greater among PRE than either SGA or NBW subjects (P<0.001). DQ through 3 yrs, IQ at 5 and 16 yrs, and SATs at 16 yrs were lower among LBW than NBW subjects (P<0.0001), with NS differences between SGA and PRE subjects. Catch-up peaked at ages 6–9 mos for wt, 12–24 mos for ht, and 18–24 mos for HC.
Conclusions: Adolescents in China who were LBW lag behind NBW peers in ht, cognitive ability, and school achievement. As the first study in China of long-term outcome, our findings suggest that these adolescents represent a population in need of support. The isolation of China and homogeneity in social and family structure during the research period provide a unique setting for the study of LBW effect but also highlight the importance of additional studies with larger in other regions of the country.
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Peng, Y., Feng, L., Huang, B. et al. 210 A 16-Year Study of Low Birth Weight Infants in China. Pediatr Res 56, 499 (2004). https://doi.org/10.1203/00006450-200409000-00233
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DOI: https://doi.org/10.1203/00006450-200409000-00233