Height at 2 and 5 years of age in children born very preterm: the EPIPAGE study

Objectives To evaluate growth for children born very preterm with particular focus on those born small-for-gestational age (SGA) or with ex utero growth restraint (GA), and to identify risk factors for short stature at 5 years of age. Study design Population-based study of children born at less than 33 completed weeks of gestation (Etude Epidemiologique sur les Petits Ages Gestationnels (EPIPAGE)). Short stature was defined as height <-2SD on WHO growth curves. Ex utero GA was considered to have occurred in children with appropriate size for gestational age at birth and with a height and/or below -2SD at 2 years of corrected age. Logistic regression models were used to test associations between risk factors and short stature. Results The authors measured height at 5 years of for 1597 of 2193 children (73%), 5.6% (95% CI 4.6 to 6.9) of whom were diagnosed as having a short Height was measured at 2 and 5 years of age in 1417 children. Among these, 24% of those born SGA and of those with ex utero GA (p=0.002) had a short at 5 years. Predictors of short stature were SGA or length <-2SD, maternal height <= 160 cm, gestational age <29 weeks and systemic corticosteroids. Breastfeeding at discharge decreased the risk of short stature. Conclusions Short stature at 5 years of age is common in children born preterm. The highest was observed in the group with ex utero GR. Systemic steroids have a long-term impact on growth and should be used with caution. Breastfeeding at discharge appeared to be protective.