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  • Clinical Research Article
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Postnatal catch-up growth in term newborns with altered fetal weight patterns. The GROWIN study

Pediatric Research volume 94, pages 1180–1188 (2023)Cite this article

Abstract

Background

Small for gestational age (SGA) perform a postnatal catch-up growth to recover their genetic trajectory. We studied the postnatal catch-up growth pattern of fetuses born with an appropriate-for-gestational-age (AGA) weight but with fetal growth deceleration (FGD) to explore whether they catch up.

Methods

Nine hundred and sixty-six newborns at Villalba University General Hospital (HUGV), were followed from 34 to 37 weeks to birth. Z-scores, adjusted for sex and age, of weight, length, and BMI at 3, 6, 9, and 12 months were calculated. We define catch-up as an increase in z-score greater than 0.67 SD in the growth curves.

Results

AGA FGD had lower mean weight and length than AGA non-FGD at all time points; BMI was lower until 3 months. AGA FGD had a lower weight, length, and BMI z-score (until 9, 6 months, and at birth, respectively) than AGA non-FGD. AGA FGD newborns had a significantly increased likelihood of weight catch-up at 3 months (OR 1.79; 95% CI: 1.16, 2.78; p = 0.009) and BMI in all investigated periods (OR 1.90; 95% CI 1.30, 2.78; p < 0.001 at 3 months), compared to AGA non-FGD newborns.

Conclusions

AGA FGD newborns perform catch-up growth, especially in weight and BMI, in the first year of life, compared to AGA non-FGD.

Impact

  • Appropriate-for-gestational-age (AGA) newborns with fetal growth deceleration (FGD), between the third trimester of pregnancy and delivery, present a lower weight and height, during the first year of life, compared to AGA non-FGD.

  • Appropriate-for-gestational-age (AGA) newborns with fetal growth deceleration (FGD), between the third trimester of pregnancy and delivery, present a higher likelihood of weight catch-up in the first 3 months of life and of BMI in the first year compared to AGA non-FGD.

  • AGA FGD experienced early weight and BMI catch-up, especially in the first 3 months of life, like SGA. This finding should be considered in the future follow-up.

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Fig. 1: Flowchart of the study cohort.
Fig. 2: Evolution of weight, length, and BMI z-scores in the first 12 months of life in the different study groups.
Fig. 3: Catch-up for non-cumulative weight, length, and BMI, with repeated measures assessment at 3, 6, 9, and 12 months.
Fig. 4: Results of the logistic regression model for catch-up for cumulative weight, length, and BMI for time intervals of 3 months up to 12 months (univariate analysis).

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Data availability

All data generated or analyzed during this study are included in this published article. The data analyzed were retrieved from the Villalba University General Hospital database. Further inquiries can be directed to the corresponding author.

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Acknowledgements

We gratefully thank all the staff of the Ultrasound and Prenatal Diagnosis Unit and Department of Neonatology of the Villalba University General Hospital (Madrid, Spain) for their help in the acquisition and management of data. We also thank Angel Pantoja Bajo from Hospital Virgen de la Salud (Toledo) and Gonzalo Ares from Hospital Universitario Rey Juan Carlos (Madrid) for their invaluable support in the achievement of this project.

Funding

This article was supported by 20th national grants for research in life sciences 2021/2021 from Ramón Areces Foundation (Spain), the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) networking grant 2021, and Spanish program for the generation of knowledge and scientific and technological strengthening of the system and oriented to the challenges of society (PID2020-119084RB-C21 funded by MCIN/AEI/10.13039/501100011033) from Ministry of Science and Innovation (Spain).

Author information

Authors and Affiliations

  1. Department of Neonatology, Villalba University General Hospital, Madrid, Spain

    María Sonsoles Galán Arévalo

  2. Biostatistics and Epidemiology Unit, Hospital Universitario Fundación Jiménez Díaz and Fundación Instituto de Investigación Sanitaria, Madrid, Spain

    Ignacio Mahillo-Fernández

  3. Neonatology, Instituto de Investigación Sanitaria del Hospital Universitario La Paz – IdiPAZ (La Paz University Hospital – Universidad Autónoma de Madrid), Madrid, Spain

    Miguel Saenz De Pipaon

  4. Escuela Universitaria Politécnica de La Almunia, University of Zaragoza, Zaragoza, Spain

    Luis Mariano Esteban

  5. Department of Paediatrics and Neonatology, Sligo University Hospital, Sligo, Ireland

    Diego Hernández Martín

  6. Primary Care Pediatrician, Alpedrete Health Center, Madrid, Spain

    Juan Rodriguez Delgado

  7. Technical Direction of Health Information System, Health Care Deputy Management, Primary Care Assistance Management, Madrid, Spain

    José Carlos Estevez Muñoz

  8. Department of Obstetrics and Gynecology, Villalba University General Hospital, Madrid, Spain

    Mercedes Andeyro-García

  9. Department of Paediatrics, Villalba University General Hospital, Madrid, Spain

    Roi Piñeiro Perez

  10. Department of Obstetrics and Gynecology, Hospital Clínico San Carlos, and Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain

    Ricardo Savirón-Cornudella

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  1. María Sonsoles Galán Arévalo
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Contributions

Conceptualization, R.S.C., M.S.G.A., M.S.P.; methodology, I.M.-F., R.S.C., M.S.G.A., M.S.P.; software, I.M.-F. and L.M.E.; validation, L.M.E.; resources, Villalba University General Hospital; data curation, R.S.-C., M.S.G.A., M.S.P., L.M.E. I.M.-F.; writing—original draft preparation, S.G.A, R.S.C., M.S.P.; writing—review and editing, I.M.-F., L.M.E., M.A.G., R.P.P., D.H.M., J.R.D., J.C.E.M.; funding acquisition, none. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Miguel Saenz De Pipaon.

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Competing interests

The authors declare no competing interests. The funders had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.

Ethics approval and consent to participate

The study was conducted in accordance with the guidelines of the Declaration of Helsinki and approved by the Clinical Research Ethics Committee of Fundación Jimenez Díaz (Madrid) (EO090-19_HGV), and the Central Research Commission of Primary Care Management (23/19). Patient consent was waived, as due to the retrospective observational nature of this study, data could be fully anonymized.

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Galán Arévalo, M.S., Mahillo-Fernández, I., Saenz De Pipaon, M. et al. Postnatal catch-up growth in term newborns with altered fetal weight patterns. The GROWIN study. Pediatr Res 94, 1180–1188 (2023). https://doi.org/10.1038/s41390-023-02593-3

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  • DOI: https://doi.org/10.1038/s41390-023-02593-3

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