Most SGA infants show rapid catch-up growth in the first year of life such that height is in the normal range by 2 years. However, around 10% fail to catch-up and remain short. This latter group generally presents to specialist growth clinics at school age. Earlier identification would facilitate monitoring of growth and timely intervention.
A 3-year, prospective population-based study was undertaken to determine the feasibility of identifying SGA babies who are short at birth, then re-measuring them at 2 years. All babies born at the Ayrshire Maternity Unit with BW <9th centile throughout 1 year (July 2008-June 2009) were identified. Length was measured and each infant categorised as follows: SGA (BW≤−2 SD); Short (BL ≤−2 SD); SGA+Short (BW&BL ≤−2 SD). Parents heights were also measured. Babies who were short were invited for review at 2 years.
During the study period 3797 babies were born, of whom 256 (6.7%) were low BW (<2500 g) and 278 (7.3%) preterm (<37 weeks), similar to current Scottish population statistics (7.0% LBW; 7.6% preterm). Of 481 (12.7%) infants with BW <9th centile, 131 (27%) were not measured, of whom 21 had BW <2nd centile (−2 SD). Parental heights were not recorded in 205 (42.6%). Of the 350 babies who were measured, 159 infants were identified as either SGA (53), Short (50) or SGA+Short (56). The incidences of SGA (2.9%) and short stature (2.8%) are slightly greater than expected.
Despite the constraints of a busy maternity unit it has proved feasible to measure birth length in most babies with BW <9th centile. A significant proportion of short babies were between the 2nd and 9th centiles for weight indicating that the upper level is a more appropriate cut-off for short stature screening. The second phase of the study re-measurement at 2 years has just begun.
03 - 05 Nov 2010
British Society for Paediatric Endocrinology and Diabetes