The Results of a National Inquiry into the Growth of Premature Children from Birth to 4 Years

Abstract

In this paper we describe the growth of a national sample of premature children who have been followed up from birth to 4 years and who, throughout this period, have been contrasted with a closely matched group of children born at term. This is the second of three papers about these children; the first (Douglas and Mogford, 1953) Illingworth (1939) found that a high proportion of the premature children attending an out-patient department were stunted and, in a later paper (Illingworth, Harvey and Jowett, 1950), showed that there is a direct relationship, that is, not limited to those children normally regarded as premature, between birth weight and subsequent physical development. Asher (1946) concluded that many premature children remain smaller than their fellows at least up to the age of 6 years. Drillien (1948) regarded the physical retardation of her sample of premature children as being a reflexion of the adverse environmental conditions associated with prematurity rather than a result of premature birth per se. Glaser, Parmelee and Plattner (1950) concluded that premature babies grow faster than mature babies during the first eight months of life and rapidly reduce their initial handicap.This list of studies could be expanded many times without yielding any more consistent guide to the physical prognosis of prematurity. There appear to be two reasons for this. First, in all studies a relatively large proportion of surviving premature children could not be traced. For example, Capper, even though he enlisted the help of the Viennese police, lost 54% of the children he was looking for, Hess et al. lost 75 % and Drillien 60 %. These great losses would not matter if it were certain that a representative sample of the premature children had been traced. But

Social class difference in catch up growth in a national British cohort

“…That is, the catching up in height of LBW infants was more pronounced in upper social classes. Douglas and Mogford19 reported similar findings in a report from the 1946 British birth cohort at age 4: “as judged by the mean differences between the pairs in both weight and height, the children of more prosperous parents have by 4 years of age a proportionately greater reduction in their handicaps of the LBW than the children in other groups. These differences, however, are not significant.” This earlier research suggests that the growth pattern is different according to social class, although the findings were based on four years follow up of a case control study consisting of 464 premature infants.…”

Health inequalities in the life course perspective

“…Parental smoking, poor housing, and nutrition habits continue to have direct effects on the child's risk of current illness [54], and on future respiratory capacity [17,48]. Rates of growth are faster in those whose families are in higher socio-economic circumstances [55]. Poor nutrition at this time has, like parental smoking, both a current and a long-term effect.…”

“…It has been shown, however, that low social class in childhood is associated with poorer adult health [94], unless combined with poor educational attainment. Rising paternal social mobility has been shown to increase educational attainment [57] and children's height growth [55]. As in education, the question of how indicators of parental and own income have their apparent effect is not known, but in childhood poor nutrition, and cold and damp housing are likely to be implicated.…”

Chapter I: Physical Growth

“…The problem of the long-term prognosis for prematurely born children was studied by Aim (9) and by Douglas and Mogford (82). Aim found the mortality rate considerably higher among prematures especially those who were plural born.…”