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Logo of archdischfnArchives of Disease in Childhood - Fetal & NeonatalView this articleSubmit a manuscriptReceive email alertsContact usBMJ
Arch Dis Child Fetal Neonatal Ed. Nov 2003; 88(6): F492–F500.
PMCID: PMC1763245

The EPICure study: growth and associated problems in children born at 25 weeks of gestational age or less

Abstract

Aim: To define growth outcomes of a geographically defined population of extremely preterm babies.

Population: The EPICure study identified all surviving children in the United Kingdom and Ireland born at [less-than-or-eq, slant] 25 weeks 6 days gestation between March and December 1995. Of 308 survivors, 283 (92%) were evaluated at 30 months of age corrected for prematurity.

Methods: Growth was measured as part of a medical and full neurodevelopmental assessment. Growth parameters were evaluated in relation to other 30 month outcomes and perinatal variables.

Results: The children were smaller in each of the five growth measures compared with published population norms: mean (SD) standard deviation scores were -1.19 (1.32) for weight, -1.40 (1.37) for head circumference, -0.70 (1.19) for height, -1.00 (1.38) for body mass index, and -0.75 (0.95) for mid-upper arm circumference. Despite being of average size at birth, children were significantly lighter with smaller head circumferences at the expected date of delivery, compared with population norms, and only weight showed later catch up, by 0.5 SD. Poorer growth was found in children whose parents reported feeding problems and with longer duration of oxygen dependency, as a marker for neonatal respiratory illness. Although severe motor disability was associated with smaller head circumference, overall there was no relation between Bayley scores and head growth.

Conclusions: Poor growth in early childhood is common in extremely preterm children, particularly when prolonged courses of systemic steroids have been given for chronic lung disease. Improving early growth must be a priority for clinical care.

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Supplementary Material

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
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Figures and Tables

Figure 1
Raw growth data for height (A), weight (B), head circumference (C), and mid-upper arm circumference (D) plotted against age corrected for prematurity for children of 25 weeks gestational age or less.
Figure 2
Mean (95% confidence interval) for weight (A; n = 233)) and head circumference (B; n = 145) standard deviation scores at birth, expected date of delivery (EDD), and 30 months of age corrected for prematurity for babies of [less-than-or-eq, slant] 23, 24, and 25 weeks ...
Figure 3
Relation between severe disability, feeding problems, and poor growth in terms of weight (top; n = 271) and head circumference (bottom; n = 278) at 20 months of corrected age for children of 25 weeks of gestational age or less. A, severe neurodevelopmental ...

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