Prediction Factors in the Determination of Final Height in Subjects Born Small for Gestational Age

Abstract

The aim of this study was to identify factors predictive of individual final height (FH) in subjects born small for gestational age (SGA). All full-term singleton subjects born SGA (birth weight and/or length <3rd percentile) during the period 1971-1978, matched with appropriate birth weight for gestational age (AGA) subjects (birth weight between 25th and 75th percentile) were followed from birth to FH and evaluated before puberty at a mean age +/- SD of 6.1 +/- 0.7 y and after puberty at a mean age of 20.8 +/- 2.0 y (subjects born SGA, n = 213; born AGA, n = 272). When adjusted for target height, a significant deficit in final height (p < 0.0001) was found in SGA as compared with AGA subjects for both male subjects (-3.99 cm with 95% confidence interval from -5.6 to -2.4) and female subjects (-3.64 cm with 95% confidence interval from -5.0 to -2.3), with 13.6% of subjects in the SGA population presenting short final stature. In a multiple regression analysis, target height and studied group (SGA or AGA) were found to be the strongest predictors of individual FH (p < 0.0001, r2 = 0.35 for male subjects, p < 0.0001, r = 0.40 for female subjects). For SGA subjects and according to a multiple stepwise linear regression model, 31% of the variability of individual FH [SD score (SDS)] and 58% of the variability of individual height gain SDS could be explained at birth from mother's height, father's height, and birth length SDS. No other variables were found to be predictive such as sex, gestational age (from 37 to 42 wk), birth weight SDS, ponderal index at birth, or risk factors during pregnancy associated with intrauterine growth retardation such as pregnancy-induced hypertension, smoking, or a history of SGA in offspring. Although a significant increase of body mass index SDS was documented before and after puberty in SGA subjects, puberty was not found to have any influence on growth outcome.

Time Course of Catch-up in Adiposity Influences Adult Anthropometry in Individuals Who Were Born Small for Gestational Age

“…Furthermore, it has been shown that children who were born SGA and displayed catch-up growth during infancy showed an increased body fat mass with a more central fat distribution in comparison with children who were born with normal birth size (6). This increased growth velocity of adiposity persists until adulthood, as evidenced by relative increase in BMI (expressed in SDS) from childhood to adulthood, leading to a significantly increased percentage of body fat mass at the age of 25 y in individuals who were born SGA in comparison with control subjects (7,8). Catch-up growth has been suspected to favor later development of long-term metabolic complications associated with reduced fetal growth (9 -12).…”

Intellectual and Psychological Performance in Males Born Small for Gestational Age With and Without Catch-Up Growth

“…Infants born short for gestational age have an increased risk of short adult stature (17)(18)(19). Data from Barker's group indicate that being small at birth is a threat to cardiovascular health, especially if obese in adulthood.…”

Intra-uterine and Genetic Influences on the Relationship Between Size at Birth and Height in Later Life: Analysis in Twins

“…Although most affected infants show some degree of catchup in growth during the first years of life (AlbertssonWikland et al, 1993;Karlberg & Albertsson-Wikland, 1995), epidemiological studies have consistently shown a positive association between size at birth (i.e. birth weight or birth length) and height in children (Albertsson-Wikland et al, 1993;Bavdekar et al, 1999;Hadders-Algra & Touwen, 1990), adolescents (Bacallao et al, 1996;Ibanez et al, 2000;Paz et al, 1993;Rantakallio & von Wendt L., 1985;Westwood et al, 1983) and adults ( Karlberg & AlbertssonWikland, 1995;Karlberg & Luo, 2000;Leger et al, 1997;Leger et al, 1998;Nielen et al, 1984;Sorensen et al, 1999). A recent study of approximately 40,000 young men showed that there was a mean difference of more than 7 cm in height between men with a low and a high birth weight (< 2500 and > 4500 g, respectively), and a mean difference of almost 10 cm in height between men who were short and those who were long at birth (< 48 and > 55 cm, respectively;Tuvemo et al, 1999).…”