Evaluation of Growth Indices as an Important Health Indicator in Children 2-4 Years Old with History of Prematurity and Low Birth Weight: A Retrospective Cohort Study in Shiraz, Referral Center in Southern Iran, During 2019-2021

In the present day, with the improvement of clinical care, the number of cases of premature and low birth weight babies who survive has increased. This group of babies usually achieve compensatory and faster growth than the average growth for their age and gender in the first two years of life. Also, small for gestational age (SGA) babies often have low birth weight (less than 2500 grams). These babies usually achieve compensatory growth at 2-3 years old. But if they cannot achieve this rapid compensatory growth, they may need therapeutic interventions including growth hormone administration. Therefore, the purpose of the present study was to determine and investigate growth indicators as an important health assessment criterion in 2-4-year-old children with a history of prematurity and low birth weight.

The present retrospective cross-sectional descriptive study was conducted in 2018-2019 on 96 children between 2 to 4 years of age who were born prematurely or with a low weight (less than 2500 grams). The hospitalization records of these children hospitalized at Hafez and Namazi hospitals of Shiraz were examined. Parents were invited to participate in the study through an online application. Growth indices including head circumference, height and weight were measured by a trained physician. Body mass index and Z-score were calculated for these indices and growth indices at birth were collected from their hospital records. The collected data were analyzed using t-test, chi-score and analysis of variance.

96 children were included in the study, 12.5% of children were small for their gestational age at the time of birth, and at the time of evaluation in the present study. All participants had reached the appropriate height and head circumference for their age, but 5 (41.6%) children were underweight. 45 (46.9%) children had growth disorder at the time of examination, 31 (32.3%) children were referred for laboratory evaluation and 3 (3.1%) children were treated with growth hormone. In this study, 33 (34.4%) children were underweight and 4 (4.2%) were short, 38 (39.6%) had a low body mass index (less than 2SD).

Premature and LBW infants need more attention for growth in follow-ups. Physicians should be aware of growth delay or arrest to do the best intervention at the time. They may need to refer to a pediatric endocrinology clinic at the proper time.