Early growth problems can affect children later on

NEW YORK (Reuters Health) - Postnatal (after birth) growth problems, especially when associated with prenatal (before birth) growth problems, are linked to lower physical size, cognitive scores, and academic achievement at age 8, according to results of a study.

Researchers examined the 8-year growth, cognitive status, behavioral status, health status, and academic achievement in low birth weight preterm infants who had failure to thrive, were small for gestational age (SGA), had failure to thrive plus SGA, or had normal growth.

Failure to thrive or FTT defines a newborn that fails to gain sufficient weight after birth, while SGA defines an infant that is smaller than normal in relation to the stage of pregnancy.

A total of 985 infants were included in the primary analysis group. Of these, 180 met the criteria for failure to thrive between 4 and 36 months' gestational corrected age.

Results of multivariate analysis revealed that children who were both SGA and FTT were the smallest in all growth variables at age 8, Dr. Patrick H. Casey and colleagues from the University of Arkansas for Medical Sciences, Little Rock report.

These children also had the lowest cognitive and academic achievement scores.

Compared with the children with normal growth, those with FTT only were significantly smaller in all growth variables and had significantly lower IQ scores.

There were no significant differences in any cognitive or academic achievement measures between children who were SGA only and those with normal growth.

The four groups did not differ in behavioral status or general health status.

"Although it is not clear whether aggressive clinical management of postnatal medical, nutritional, and social issues can normalize postnatal growth and improve long-term neurodevelopmental outcomes, our results emphasize the importance of considering postnatal growth status when assessing the long-term course of low birth weight preterm infants," Casey's team concludes.

SOURCE: Pediatrics September 2006.