Catch-up growth and associated factors in very low birth weight infants

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Nonetheless, the follow-up of these patients, despite the presence of contradictory data, suggests that their catch-up growth could occur at a later stage, and therefore have an impact on future adult size.<a class="elsevierStyleCrossRefs" href="#bib0025">5–7</a>Little is known about the factors that determine whether catch-up growth occurs in VPT or VLBW infants, but there is evidence that low birth weight or prematurity and medical complications are negatively correlated to postnatal growth.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> On the other hand, few authors have analysed the catch-up growth in weight of these children in relation to the concurrent catch-up growth in height, although unsurprisingly previous studies have found a positive correlation between energy intake and postnatal growth in preterm infants.<a class="elsevierStyleCrossRefs" href="#bib0040">8,9</a>The objective of our study was to make a longitudinal descriptive analysis of anthropometric measurements in a cohort of very low birth weight (VLBW) infants from birth to 14 years of age, and then analyse the characteristics of catch-up growth in height and some associated factors in these patients.MethodsParticipantsThe official child wellness programme of the public health system of the region of Navarre in Spain includes regular health screenings during which anthropometric measurements (weight and height) are documented in the clinical records, at birth and at ages 1, 2, 3, 4, 6, 8, 10, 12 and 14 years.Within this framework, the anthropometric measurements considered in our study (weight and height) corresponding to birth and ages 1, 2, 3, 4, 6, 8, 10, 12 and 14 years had been recorded for the cohort of VLBW infants (<1500 g). The inclusion criteria were being Caucasian and born to Caucasian Spanish parents, and birth in the Neonatal Unit of the Complejo Hospitalario de Navarra between January 2001 and December 2005.The weight and height measurements were made with the children in their undergarments and barefoot. Weight was measured using an Año-Sayol scale (range of 0–120 kg and accurate to 100 g), and height was measured with a Holtain wall stadiometer (range of 60–210 cm and accurate to 0.1 cm).We found records for 217 births of VLBW infants in this period, of which we excluded 47 for different reasons: perinatal mortality in 20 (9.2%), severe malformations and/or chromosomal disorder in 6 (2.8%), severe neurosensory impairment and motor sequelae in 5 (2.3%), non-Caucasian descent in 8 (3.7%) and other reasons (distance to hospital, lack of continuity in paediatric health screenings, etc.) in 8 cases (3.7%).We classified the VLBW infants included in the study into two groups: those born with weight appropriate for gestational age (AGA) and those small for gestational age (SGA), based on whether the birth weight and/or length where or not 2 or more standard deviations below the mean for gestational sex and age of the reference population. The growth reference charts for newborns that we used in this came from the Spanish cross-sectional growth study by Carrascosa et al.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> We considered infants with birth weights of less than 1000 g extremely low birth weight (ELBW). We categorised preterm birth based on gestational age (GA) into extremely preterm (EPT, GA < 28 weeks), very preterm (VPT, GA = 28–32 weeks) and late preterm (LPT, GA = 32–37 weeks).On the other hand, we obtained a control group from an observational epidemiological study carried out in an infant population (healthy full-term infants, Caucasian and children from Caucasian parents, 482 male and 448 female) in who anthropometric measurements were taken on a similar schedule to the one followed in the cohort of VLBW infants.<a class="elsevierStyleCrossRef" href="#bib0055">11</a>We defined adequate catch-up growth in either height or weight in VLBW infants as the height or weight, as applicable, being above the value of 2 standard deviations below the mean in the growth charts of the control group.<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a>Statistical analysisWe summarised the data as percentages (%) and mean values with the corresponding standard deviations (SD) and 95% confidence intervals (CIs). We performed the statistical analysis (descriptive statistics, Student t test, analysis of variance, chi square test and multiple logistic regression analysis) with the Statistical Package for the Social Sciences (SPSS) version 20.0 (Chicago, IL, USA). We defined the threshold of statistical significance at a p-value of 0.05.The study was approved by the Ethics Committee for Research in Humans of the Complejo Hospitalario de Navarra, Pamplona, Spain, and conducted in adherence to the ethical standards of the Declaration of Hensinki of 1964 and later amendments. The parents and/or legal guardians of children included in the study gave their informed consent for participation.ResultsThe sample included 170 VLBW infants (82 male and 88 female), of who 42.4% were product of multiple pregnancies (n = 72). Out of all infants born with VLBW, 40.6% (n = 69) were small for gestational age (SGA group) and the remaining 59.4% (n = 101) appropriate for gestational age (AGA group). Within the SGA group, both weight and length were affected in 59.4% of the infants (n = 41), while only length was abnormal in 23.2% (n = 16) and only weight in 17.4% (n = 12). Thirty-seven (21.8%) were considered ELBW. The distribution of infants born preterm by GA was 18.8% extremely preterm (n = 32), 42.4% very preterm (n = 72), and 38.8% late preterm (n = 66).<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents and compares the anthropometric values at birth of VLBW infants in the AGA and SGA groups and by sex. We found no statistically significant differences in the mean weight and height values at birth between the 2 groups. Gestational age was significantly higher in the SGA group compared to the AGA group.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> presents the percentage of VLBW infants who had achieved a normal height at the different ages considered in the study. At age 2, 4 and 10 years, 49.4%, 78.9% and 87.1% of infants, respectively, had achieved a normal height. Thus, 8.2% of VLBW infants reached normal height between ages 4 and 10 years.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Our results show that 86% of VLBW infants that had achieved a normal weight after the first year of life achieved a normal height (P < 0.001) by age 2 years. In addition, 98.6% of VLBW infants with a normal weight at age 2 years had achieved a normal height (P < 0.001) by age 4 years. Similarly, 97.2% of VLBW infants with normal weight at age 4 years had normal heights (P < 0.001) by age 10 years, 99.2% of VLBW infants with normal weights at age 6 years had normal heights by age 8 years (P < 0.001), and lastly, all VLBW infants that had normal weights at age 10 years also had normal heights at this time point (P < 0.001).<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> presents and compares the percentages of individuals in the AGA and SGA groups that reached normal size at the different ages under consideration. We found no statistically significant differences between groups, except at age 10: 17% of children in the SGA group (n = 12) and 10% of children in the AGA group (n = 10) had low height (P = 0.018).<elsevierMultimedia ident="fig0010"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> presents and compares the percentages of children born with VLBW (1000–1500 g; n = 133) and children born with ELBW (<1000 g; n = 37) that achieved a normal height at the different ages under consideration. We found significant differences between groups at every age. At age 10 years, 7% of children born with VLBW (n = 9) and 35% of children born with ELBW (n = 13) had short stature (P = 0.001).<elsevierMultimedia ident="fig0015"></elsevierMultimedia>In the SGA group, of the 12 children that had short stature at age 10 years (7 of who were ELBW), 7 had achieved a normal height by age 14 years (of who 6 had undergone treatment with recombinant human growth hormone [rhGH]), while the remaining 5 out of 12 children (3 of who were ELBW) continued to have short stature (3 had undergone treatment with rhGH). Treatment with rhGH was initiated between ages 6.5 and 8.3 years.In the AGA group, of the 10 children that had short stature at age 10 years (7 of who were ELBW) 2 had reached a normal height at 14 years (1 had received rhGH therapy at age 8.9 years) and 8 (6 of them ELBW) continued to have short stature (1 started rhGH therapy at age 7.8 years, and 7 were not eligible for treatment due to normal responses in growth hormone stimulation tests).<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the results of the multiple logistic regression analysis performed to study the association of neonatal characteristics with inadequate catch-up growth in height at ages 2, 4, and 10 years. We found that ELBW, SGA with only abnormal height and preterm birth before 28 weeks’ gestation were associated with inadequate catch-up growth in height at 2, 4, and 10 years of age. On the other hand, SGA with abnormal weight and height was associated with inadequate catch-up growth only through age 10 years, while preterm birth between 28 to 32 weeks’ gestation was associated with inadequate catch-up growth only at ages 2 and 4 years. Furthermore, multiple birth was not associated with inadequate catch-up growth at ages 2, 4 or 10 years.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>DiscussionFoetal development and growth are complex processes based on continuous and harmonious cellular proliferation and differentiation. The literature describes multiple factors (maternal, foetal, placental and environmental) that have a deleterious impact on the foetus and trigger a series of functional and structural adaptive changes that result in restricted foetal growth (in what is known as the “thrifty phenotype hypothesis”), accompanied by several changes in hormone sensitivity and/or secretion associated with an increased risk of developing metabolic and/or endocrine disorders in adult life.<a class="elsevierStyleCrossRefs" href="#bib0060">12,13</a> Nevertheless, after birth, most infants born to term with a history of intrauterine growth restriction exhibit an accelerated compensatory growth (catch-up growth), especially in the first year of life, that allows approximately 90% to exceed the threshold of 2 SDs below the mean in the reference population, or, in other words, to reach a normal height.<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a> However, when this compensatory growth does not take place, they are not likely to achieve a normal final height in adulthood. This is one of the indications for rhGH therapy approved by the United States Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the Growth Hormone Research Society, whose aim is to accelerate the initial compensatory growth and/or to maintain a normal growth velocity.<a class="elsevierStyleCrossRefs" href="#bib0015">3,14,15</a>Advances in obstetric and perinatal care in recent decades have achieved a substantial decrease in the mortality of VLBW infants; however, given the potential sensorineural morbidity in this population, these patients are usually included in follow-up programmes whose purpose is the early detection of neurodevelopmental problems.<a class="elsevierStyleCrossRefs" href="#bib0005">1,16</a> The optimization of these programmes has facilitated the standardization of dietary and nutritional recommendations, and allowed growth monitoring in the first years of life. It also allows the analysis, such as the one performed by our group, of the evolution of anthropometric variables in VLBW infants.Our study shows that catch-up height gain in VLBW infants is either lesser or slower compared to infants born full-term and SGA.<a class="elsevierStyleCrossRefs" href="#bib0020">4–10</a> In fact, at ages 2, 4 and 10 years, 50.6%, 21.1% and 12.9% of children in our sample, respectively, still had short stature; therefore, while a similar proportion of VLBW infants achieved a normal height compared to full-term SGA infants at age 2, between ages 4 and 10 years barely 8.2% of VLBW infants achieved a normal height. Although these data may seem contradictory, the results are somewhat consistent with those reported by different authors that had already warned of a potential delay in the catch-up growth of VLBW infants.<a class="elsevierStyleCrossRefs" href="#bib0085">17–23</a> However, none of these authors have analysed the impact of catch-up weight gain, which is concurrent with catch-up height gain and, based on the obtained data, seems to play a determinant role.<a class="elsevierStyleCrossRefs" href="#bib0040">8,9</a> In fact, almost all children that had achieved a normal height by the check-ups at ages 2, 4 and 10 years had a normal weight in the preceding check-up. Thus, VLBW infants should be subject to strict nutritional monitoring, possibly with prescription of nutritional supplements, with the aim of achieving complete catch-up growth in weight as early as possible.The findings of our study have immediate clinical repercussions. First, the comparison of the patterns of catch-up height gain in AGA and SGA groups showed only small differences in the age range under study, except at age 10. However, at age 10, while only 1 out of the 10 children did not reach a normal height in the AGA group, approximately 1 in 5 individuals in the SGA group continued to have short stature. This means that the lower rate or slower pace of catch-up growth in VLBW infants is slightly further reduced or delayed in SGA infants. On the other hand, it is also important to highlight that between ages 2 and 4 years, 1 in 3 children achieved a normal height in both the AGA and the SGA groups. This finding suggests that applying the recommendation of the EMA and the Growth Hormone Research Society of postponing initiation of rhGH therapy until age 4 years would be more appropriate than applying the recommendation of the FDA, which proposes initiation of treatment at age 2 years.The analysis of catch-up growth in ELBW infants deserves special consideration. On one hand, we found that most children that had not reached a normal height by age 10 years in both the AGA and the SGA groups were patients born with ELBW. On the other hand, there was a remarkable number of children in the AGA group who, in agreement with the current recommendations of the FDA, the EMA and the Growth Hormone Research Society, did not receive hormone therapy when the response to the growth hormone stimulation test was normal. This may largely explain why children in the AGA group with short stature at age 10 years (most of who were VLBW) continued to have short stature at age 14 years and, presumably, in adulthood. Given that current guidelines do not consider the possibility of starting growth hormone therapy in individuals born AGA and with normal GH secretion, we should consider whether these criteria should be modified in the case of children born with VLBW and, specially, those with ELBW. The multiple logistic regression analysis confirmed that ELBW and EPT infants were at higher risk of inadequate catch-up height gain at 2, 4, and 10 years of age, associated with an increased risk of short stature in adulthood. These findings support the hypothesis that they could benefit from GH treatment, regardless of whether their birth weight and/or length was appropriate for gestational age or not.<a class="elsevierStyleCrossRefs" href="#bib0030">6,24–26</a>The growth pattern of children born preterm has specific characteristics. Approximately 85% and 53% of VLBW and ELBW infants, respectively, will have reached a normal height by 4 years of age. However, those with short stature at age 4 years are not likely to reach a normal height in childhood. Catch-up weight gain seems to be an important factor for catch-up height gain, and therefore we recommend a rigorous nutritional follow-up in these children. If despite this follow-up these children do not exhibit improved catch-up height gain, they may be eligible for rhGH therapy.Declaration of Competing InterestThe authors declare no conflicts of interest.Author contributionsTDT and ISG participated in the study design and the analysis of the data, and wrote the first draft of the manuscript. FGV, MJCG and SBZ participated in the collection and analysis of data. All authors contributed to the writing of the manuscript and approved its final version." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1415763" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1295601" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1415764" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1295602" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Participants" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec5040" "titulo" => "Declaration of Competing Interest" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Author contributions" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-05-23" "fechaAceptado" => "2019-06-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1295601" "palabras" => array:5 [ 0 => "Catch-up growth" 1 => "Intrauterine growth restriction" 2 => "Preterm infant" 3 => "Very low birth weight infant" 4 => "Growth pattern" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1295602" "palabras" => array:5 [ 0 => "Crecimiento recuperador" 1 => "Retraso de crecimiento intrauterino" 2 => "Recién nacido prematuro" 3 => "Recién nacido de muy bajo peso" 4 => "Patrón de crecimiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThe characteristics of catch-up growth in very low birth weight infants (VLBW) have not been clearly established. The aim of this study was to analyse the height catch-up and some associated factors in a cohort of VLBW birth weight <1,500 g from birth to age 14 years. MethodsWe obtained retrospective data on weight and height at birth and ages one, 2, 3, 4, 6, 8, 10, 12 and 14 years in a cohort of 170 VLBW. We compared these anthropometric values with those documented in a control group. ResultsThirty-seven children (21.8%) were born with an extremely low birth weight and 32 (18.8%) extremely preterm. At 10 years of age, 7% of VLBW (1,000–1,500 g) and 35% of extremely low birth weight <1,500 g children had short stature P = 0.001). Almost all VLBW children who had a normal height at ages 2, 4 and 10 years had exhibited adequate weight catch-up in previous evaluations. We found that extremely low birth weight and extremely preterm were independent predictors for inadequate height catch-up. ConclusionThe growth pattern of VLBW children has specific characteristics. The catch-up in weight seems to be an important factor for catch-up in height, and therefore a thorough nutritional follow-up is recommended in these children." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLas características del crecimiento recuperador en niños con muy bajo peso (MBP) al nacer no se han establecido con claridad. El objetivo del estudio fue analizar el crecimiento recuperador de talla y factores asociados en una cohorte de niños con MBP al nacer (< 1.500 g) desde el nacimiento hasta los 14 años de edad. MétodosSe recogieron datos retrospectivos de peso y talla a uno, 2, 3, 4, 6, 8, 10, 12 y 14 años de edad en una cohorte de 170 recién nacidos con MBP. Se compararon estos datos antropométricos con los registrados en un grupo de control. ResultadosTreinta y siete niños (21.8%) nacieron con extremado bajo peso y 32 (18.8%) fueron pretérmino extremo. A los 10 años de edad, el 7% de los niños con MBP (1.000-1.500 g) y el 35% de los niños con extremado bajo peso < 1.500 g tenían talla baja p = 0,001. Casi todos los niños con MBP que tenían una talla normal a los 2, 4 y 10 años de edad habían alcanzado un peso adecuado en evaluaciones previas. El extremado bajo peso al nacer y el nacimiento pretérmino extremo resultaron ser predictores independientes de un crecimiento recuperador de talla inadecuado. ConclusiónEl patrón de crecimiento de niños con MBP al nacer tiene unas características específicas. El crecimiento recuperador de peso parece ser un factor importante para el crecimiento recuperador de talla, por lo que se recomienda un seguimiento nutricional cuidadoso en estos niños." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Durá-Travé T, et al. Crecimiento recuperador y factores asociados en niños de muy bajo peso al nacer. An Pediatr (Barc). 2020;93:282–288." ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 984 "Ancho" => 2178 "Tamanyo" => 72917 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Percentages of complete catch-up growth in height in VLBW infants." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1018 "Ancho" => 2161 "Tamanyo" => 99202 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Percentages of complete catch-up growth in height in AGA and SGA groups (chi square test)." ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1032 "Ancho" => 2156 "Tamanyo" => 100681 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Percentages of complete catch-up growth in height in ELBW and VLBW infants (chi square test)." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "(*) Student t test, P < 0.05 in comparison of AGA and SGA.AGA, appropriate for gestational age; SGA, small for gestational age." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Male</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Female</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AGA group(n = 52) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SGA group(n = 30) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AGA group(n = 49) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SGA group(n = 39) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gestational age*(weeks) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.7 ± 1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.3 ± 1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.9 ± 2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.6 ± 3.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Weight (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1204.3 ± 222.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1257.4 ± 179.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1145.8 ± 229.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1134.0 ± 256.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Height (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.3 ± 3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.0 ± 2.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.2 ± 2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37.4 ± 3.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2429258.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Gestational age, birth weight and birth length of VLBW infants by sex (mean ± SD)." ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "AGA, appropriate for gestational age; ELBW, extremely low birth weight; EPT, extremely preterm; LPT, late preterm; SGA, small for gestational age; VLBW: very low birth weight; VPT, very preterm." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inadequate catch-up height gain</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age 2 yearsOR (95% CI) P \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age 4 years OR (95% CI) P \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age 10 years OR (95% CI) P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Birth weight</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VLBW (1000−1500 g), n = 133 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ELBW (<1000 g), n = 37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.9 (3.3–24.5) 0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.9 (3.6–13.6) 0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.3 (2.1–13.4) 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AGA group, n = 69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SGA group (weight/height), n = 41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.6 (0.8–2.9) 0.150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 (0.7–3.1) 0.300 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.6 (1.1–6.4) 0.038 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AGA group, n = 69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SGA group (only weight), n = 12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 (0.7–2.7) 0.291 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.3 (0.6–2.9) 0.457 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 (0.9–5.5) 0.069 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AGA group, n = 69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SGA group (only height), n = 16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.0 (1.3–1.7) 0.048 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 (1.2–4.0) 0.033 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.8 (1.1–6.8) 0.024 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Type of pregnancy</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single, n = 98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Multiple, n = 72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9 (0.5–1.5) 0.620 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9 (0.4–1.9) 0.862 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 (0.6–3.6) 0.431 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gestational age at birth</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32–37 weeks (LPT), n = 66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reference group \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><28 weeks (EPT), n = 72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5(1.1–5.9) 0.035 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.2(2.6–19.8) 0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.5(1.3–14.9) 0.015 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28–32 weeks (VPT), n = 32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.6(1.1.6.4) 0.033 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.2(1.6–10.8) 0.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9(0.7–5.3) 0.242 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2429259.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Logistic regression analysis of factors associated with inadequate catch-up growth." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adults born preterm: a review of general health and system-specific outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T.N.K. Raju" 1 => "S. Buist" 2 => "C.J. Blaisdell" 3 => "M. Moxey-Mims" 4 => "S. Saigal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/apa.13880" "Revista" => array:6 [ "tituloSerie" => "Acta Paediatr" "fecha" => "2017" "volumen" => "106" "paginaInicial" => "1409" "paginaFinal" => "1437" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28419544" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International Small for gestational age advisory board consensus development conference statement: management of short children born small for gestational age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P.A. Lee" 1 => "S.D. Chernausek" 2 => "A.C.S. Hokken-Koelega" 3 => "P. 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Catch-up growth and associated factors in very low birth weight infants

Crecimiento recuperador y factores asociados en niños de muy bajo peso al nacer

Teodoro Durá-Travéa,b,c,

Corresponding author

tduratra@cfnavarra.es

Corresponding author.

, Isabel San Martín-Garcíab, Fidel Gallinas-Victorianob, María Jesús Chueca-Guindulainb,c, Sara Berrade-Zubirib,c

a Departamento de Pediatría, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, Spain

b Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain

c Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Infants born to term with a history of intrauterine growth restriction constitute a heterogeneous population with multifactorial health problems and&#44; in addition to exhibiting a higher morbidity and mortality&#44; are at increased risk of cardiovascular and&#47;or metabolic disease in adult life&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These patients show an accelerated compensatory growth pattern &#40;catch-up growth&#41; that is usually complete by age 2 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> However&#44; the characteristics of catch-up growth have not been well established in very preterm &#40;VPT&#41; infants &#40;born before 32 weeks&#8217; gestation&#41; or very low birth weight &#40;VLBW&#41; infants &#40;birth weight &#60; 1500&#8239;g&#41;&#46; Nonetheless&#44; the follow-up of these patients&#44; despite the presence of contradictory data&#44; suggests that their catch-up growth could occur at a later stage&#44; and therefore have an impact on future adult size&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#8211;7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Little is known about the factors that determine whether catch-up growth occurs in VPT or VLBW infants&#44; but there is evidence that low birth weight or prematurity and medical complications are negatively correlated to postnatal growth&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> On the other hand&#44; few authors have analysed the catch-up growth in weight of these children in relation to the concurrent catch-up growth in height&#44; although unsurprisingly previous studies have found a positive correlation between energy intake and postnatal growth in preterm infants&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The objective of our study was to make a longitudinal descriptive analysis of anthropometric measurements in a cohort of very low birth weight &#40;VLBW&#41; infants from birth to 14 years of age&#44; and then analyse the characteristics of catch-up growth in height and some associated factors in these patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Participants</span><p id="par0020" class="elsevierStylePara elsevierViewall">The official child wellness programme of the public health system of the region of Navarre in Spain includes regular health screenings during which anthropometric measurements &#40;weight and height&#41; are documented in the clinical records&#44; at birth and at ages 1&#44; 2&#44; 3&#44; 4&#44; 6&#44; 8&#44; 10&#44; 12 and 14 years&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Within this framework&#44; the anthropometric measurements considered in our study &#40;weight and height&#41; corresponding to birth and ages 1&#44; 2&#44; 3&#44; 4&#44; 6&#44; 8&#44; 10&#44; 12 and 14 years had been recorded for the cohort of VLBW infants &#40;&#60;1500&#8239;g&#41;&#46; The inclusion criteria were being Caucasian and born to Caucasian Spanish parents&#44; and birth in the Neonatal Unit of the Complejo Hospitalario de Navarra between January 2001 and December 2005&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The weight and height measurements were made with the children in their undergarments and barefoot&#46; Weight was measured using an A&#241;o-Sayol scale &#40;range of 0&#8211;120&#8239;kg and accurate to 100&#8239;g&#41;&#44; and height was measured with a Holtain wall stadiometer &#40;range of 60&#8211;210&#8239;cm and accurate to 0&#46;1&#8239;cm&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We found records for 217 births of VLBW infants in this period&#44; of which we excluded 47 for different reasons&#58; perinatal mortality in 20 &#40;9&#46;2&#37;&#41;&#44; severe malformations and&#47;or chromosomal disorder in 6 &#40;2&#46;8&#37;&#41;&#44; severe neurosensory impairment and motor sequelae in 5 &#40;2&#46;3&#37;&#41;&#44; non-Caucasian descent in 8 &#40;3&#46;7&#37;&#41; and other reasons &#40;distance to hospital&#44; lack of continuity in paediatric health screenings&#44; etc&#46;&#41; in 8 cases &#40;3&#46;7&#37;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">We classified the VLBW infants included in the study into two groups&#58; those born with weight appropriate for gestational age &#40;AGA&#41; and those small for gestational age &#40;SGA&#41;&#44; based on whether the birth weight and&#47;or length where or not 2 or more standard deviations below the mean for gestational sex and age of the reference population&#46; The growth reference charts for newborns that we used in this came from the Spanish cross-sectional growth study by Carrascosa et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> We considered infants with birth weights of less than 1000&#8239;g extremely low birth weight &#40;ELBW&#41;&#46; We categorised preterm birth based on gestational age &#40;GA&#41; into extremely preterm &#40;EPT&#44; GA&#8239;&#60;&#8239;28 weeks&#41;&#44; very preterm &#40;VPT&#44; GA&#8239;&#61;&#8239;28&#8211;32 weeks&#41; and late preterm &#40;LPT&#44; GA&#8239;&#61;&#8239;32&#8211;37 weeks&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">On the other hand&#44; we obtained a control group from an observational epidemiological study carried out in an infant population &#40;healthy full-term infants&#44; Caucasian and children from Caucasian parents&#44; 482 male and 448 female&#41; in who anthropometric measurements were taken on a similar schedule to the one followed in the cohort of VLBW infants&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">We defined adequate catch-up growth in either height or weight in VLBW infants as the height or weight&#44; as applicable&#44; 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Pamplona&#44; Spain&#44; and conducted in adherence to the ethical standards of the Declaration of Hensinki of 1964 and later amendments&#46; The parents and&#47;or legal guardians of children included in the study gave their informed consent for participation&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The sample included 170 VLBW infants &#40;82 male and 88 female&#41;&#44; of who 42&#46;4&#37; were product of multiple pregnancies &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;72&#41;&#46; Out of all infants born with VLBW&#44; 40&#46;6&#37; &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;69&#41; were small for gestational age &#40;SGA group&#41; and the remaining 59&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;101&#41; appropriate for gestational age &#40;AGA group&#41;&#46; Within the SGA group&#44; both weight and length were affected in 59&#46;4&#37; of the infants &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;41&#41;&#44; while only length was abnormal in 23&#46;2&#37; &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;16&#41; and only weight in 17&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;12&#41;&#46; Thirty-seven &#40;21&#46;8&#37;&#41; were considered ELBW&#46; The distribution of infants born preterm by GA was 18&#46;8&#37; extremely preterm &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;32&#41;&#44; 42&#46;4&#37; very preterm &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;72&#41;&#44; and 38&#46;8&#37; late preterm &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;66&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents and compares the anthropometric values at birth of VLBW infants in the AGA and SGA groups and by sex&#46; We found no statistically significant differences in the mean weight and height values at birth between the 2 groups&#46; Gestational age was significantly higher in the SGA group compared to the AGA group&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> presents the percentage of VLBW infants who had achieved a normal height at the different ages considered in the study&#46; At age 2&#44; 4 and 10 years&#44; 49&#46;4&#37;&#44; 78&#46;9&#37; and 87&#46;1&#37; of infants&#44; respectively&#44; had achieved a normal height&#46; Thus&#44; 8&#46;2&#37; of VLBW infants reached normal height between ages 4 and 10 years&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Our results show that 86&#37; of VLBW infants that had achieved a normal weight after the first year of life achieved a normal height &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;0&#46;001&#41; by age 2 years&#46; In addition&#44; 98&#46;6&#37; of VLBW infants with a normal weight at age 2 years had achieved a normal height &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;0&#46;001&#41; by age 4 years&#46; Similarly&#44; 97&#46;2&#37; of VLBW infants with normal weight at age 4 years had normal heights &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;0&#46;001&#41; by age 10 years&#44; 99&#46;2&#37; of VLBW infants with normal weights at age 6 years had normal heights by age 8 years &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;0&#46;001&#41;&#44; and lastly&#44; all VLBW infants that had normal weights at age 10 years also had normal heights at this time point &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;0&#46;001&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> presents and compares the percentages of individuals in the AGA and SGA groups that reached normal size at the different ages under consideration&#46; We found no statistically significant differences between groups&#44; except at age 10&#58; 17&#37; of children in the SGA group &#40;<span class="elsevierStyleItalic">n&#8239;&#61;</span>&#8239;12&#41; and 10&#37; of children in the AGA group &#40;<span class="elsevierStyleItalic">n&#8239;&#61;</span>&#8239;10&#41; had low height &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;0&#46;018&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> presents and compares the percentages of children born with VLBW &#40;1000&#8211;1500&#8239;g&#59; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;133&#41; and children born with ELBW &#40;&#60;1000&#8239;g&#59; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;37&#41; that achieved a normal height at the different ages under consideration&#46; We found significant differences between groups at every age&#46; At age 10 years&#44; 7&#37; of children born with VLBW &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;9&#41; and 35&#37; of children born with ELBW &#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;13&#41; had short stature &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;0&#46;001&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">In the SGA group&#44; of the 12 children that had short stature at age 10 years &#40;7 of who were ELBW&#41;&#44; 7 had achieved a normal height by age 14 years &#40;of who 6 had undergone treatment with recombinant human growth hormone &#91;rhGH&#93;&#41;&#44; while the remaining 5 out of 12 children &#40;3 of who were ELBW&#41; continued to have short stature &#40;3 had undergone treatment with rhGH&#41;&#46; Treatment with rhGH was initiated between ages 6&#46;5 and 8&#46;3 years&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In the AGA group&#44; of the 10 children that had short stature at age 10 years &#40;7 of who were ELBW&#41; 2 had reached a normal height at 14 years &#40;1 had received rhGH therapy at age 8&#46;9 years&#41; and 8 &#40;6 of them ELBW&#41; continued to have short stature &#40;1 started rhGH therapy at age 7&#46;8 years&#44; and 7 were not eligible for treatment due to normal responses in growth hormone stimulation tests&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the results of the multiple logistic regression analysis performed to study the association of neonatal characteristics with inadequate catch-up growth in height at ages 2&#44; 4&#44; and 10 years&#46; We found that ELBW&#44; SGA with only abnormal height and preterm birth before 28 weeks&#8217; gestation were associated with inadequate catch-up growth in height at 2&#44; 4&#44; and 10 years of age&#46; On the other hand&#44; SGA with abnormal weight and height was associated with inadequate catch-up growth only through age 10 years&#44; while preterm birth between 28 to 32 weeks&#8217; gestation was associated with inadequate catch-up growth only at ages 2 and 4 years&#46; Furthermore&#44; multiple birth was not associated with inadequate catch-up growth at ages 2&#44; 4 or 10 years&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">Foetal development and growth are complex processes based on continuous and harmonious cellular proliferation and differentiation&#46; The literature describes multiple factors &#40;maternal&#44; foetal&#44; placental and environmental&#41; that have a deleterious impact on the foetus and trigger a series of functional and structural adaptive changes that result in restricted foetal growth &#40;in what is known as the &#8220;thrifty phenotype hypothesis&#8221;&#41;&#44; accompanied by several changes in hormone sensitivity and&#47;or secretion associated with an increased risk of developing metabolic and&#47;or endocrine disorders in adult life&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a> Nevertheless&#44; after birth&#44; most infants born to term with a history of intrauterine growth restriction exhibit an accelerated compensatory growth &#40;<span class="elsevierStyleItalic">catch-up growth</span>&#41;&#44; especially in the first year of life&#44; that allows approximately 90&#37; to exceed the threshold of 2 SDs below the mean in the reference population&#44; or&#44; in other words&#44; to reach a normal height&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> However&#44; when this compensatory growth does not take place&#44; they are not likely to achieve a normal final height in adulthood&#46; This is one of the indications for rhGH therapy approved by the United States Food and Drug Administration &#40;FDA&#41;&#44; the European Medicines Agency &#40;EMA&#41; and the Growth Hormone Research Society&#44; whose aim is to accelerate the initial compensatory growth and&#47;or to maintain a normal growth velocity&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;14&#44;15</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Advances in obstetric and perinatal care in recent decades have achieved a substantial decrease in the mortality of VLBW infants&#59; however&#44; given the potential sensorineural morbidity in this population&#44; these patients are usually included in follow-up programmes whose purpose is the early detection of neurodevelopmental problems&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;16</span></a> The optimization of these programmes has facilitated the standardization of dietary and nutritional recommendations&#44; and allowed growth monitoring in the first years of life&#46; It also allows the analysis&#44; such as the one performed by our group&#44; of the evolution of anthropometric variables in VLBW infants&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Our study shows that catch-up height gain in VLBW infants is either lesser or slower compared to infants born full-term and SGA&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;10</span></a> In fact&#44; at ages 2&#44; 4 and 10 years&#44; 50&#46;6&#37;&#44; 21&#46;1&#37; and 12&#46;9&#37; of children in our sample&#44; respectively&#44; still had short stature&#59; therefore&#44; while a similar proportion of VLBW infants achieved a normal height compared to full-term SGA infants at age 2&#44; between ages 4 and 10 years barely 8&#46;2&#37; of VLBW infants achieved a normal height&#46; Although these data may seem contradictory&#44; the results are somewhat consistent with those reported by different authors that had already warned of a potential delay in the catch-up growth of VLBW infants&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#8211;23</span></a> However&#44; none of these authors have analysed the impact of catch-up weight gain&#44; which is concurrent with catch-up height gain and&#44; based on the obtained data&#44; seems to play a determinant role&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a> In fact&#44; almost all children that had achieved a normal height by the check-ups at ages 2&#44; 4 and 10 years had a normal weight in the preceding check-up&#46; Thus&#44; VLBW infants should be subject to strict nutritional monitoring&#44; possibly with prescription of nutritional supplements&#44; with the aim of achieving complete catch-up growth in weight as early as possible&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The findings of our study have immediate clinical repercussions&#46; First&#44; the comparison of the patterns of catch-up height gain in AGA and SGA groups showed only small differences in the age range under study&#44; except at age 10&#46; However&#44; at age 10&#44; while only 1 out of the 10 children did not reach a normal height in the AGA group&#44; approximately 1 in 5 individuals in the SGA group continued to have short stature&#46; This means that the lower rate or slower pace of catch-up growth in VLBW infants is slightly further reduced or delayed in SGA infants&#46; On the other hand&#44; it is also important to highlight that between ages 2 and 4 years&#44; 1 in 3 children achieved a normal height in both the AGA and the SGA groups&#46; This finding suggests that applying the recommendation of the EMA and the Growth Hormone Research Society of postponing initiation of rhGH therapy until age 4 years would be more appropriate than applying the recommendation of the FDA&#44; which proposes initiation of treatment at age 2 years&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The analysis of catch-up growth in ELBW infants deserves special consideration&#46; On one hand&#44; we found that most children that had not reached a normal height by age 10 years in both the AGA and the SGA groups were patients born with ELBW&#46; On the other hand&#44; there was a remarkable number of children in the AGA group who&#44; in agreement with the current recommendations of the FDA&#44; the EMA and the Growth Hormone Research Society&#44; did not receive hormone therapy when the response to the growth hormone stimulation test was normal&#46; This may largely explain why children in the AGA group with short stature at age 10 years &#40;most of who were VLBW&#41; continued to have short stature at age 14 years and&#44; presumably&#44; in adulthood&#46; Given that current guidelines do not consider the possibility of starting growth hormone therapy in individuals born AGA and with normal GH secretion&#44; we should consider whether these criteria should be modified in the case of children born with VLBW and&#44; specially&#44; those with ELBW&#46; The multiple logistic regression analysis confirmed that ELBW and EPT infants were at higher risk of inadequate catch-up height gain at 2&#44; 4&#44; and 10 years of age&#44; associated with an increased risk of short stature in adulthood&#46; These findings support the hypothesis that they could benefit from GH treatment&#44; regardless of whether their birth weight and&#47;or length was appropriate for gestational age or not&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;24&#8211;26</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">The growth pattern of children born preterm has specific characteristics&#46; Approximately 85&#37; and 53&#37; of VLBW and ELBW infants&#44; respectively&#44; will have reached a normal height by 4 years of age&#46; However&#44; those with short stature at age 4 years are not likely to reach a normal height in childhood&#46; Catch-up weight gain seems to be an important factor for catch-up height gain&#44; and therefore we recommend a rigorous nutritional follow-up in these children&#46; If despite this follow-up these children do not exhibit improved catch-up height gain&#44; they may be eligible for rhGH therapy&#46;</p></span><span id="sec5040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect3100">Declaration of Competing Interest</span><p id="par6180" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Author contributions</span><p id="par0140" class="elsevierStylePara elsevierViewall">TDT and ISG participated in the study design and the analysis of the data&#44; and wrote the first draft of the manuscript&#46; FGV&#44; MJCG and SBZ participated in the collection and analysis of data&#46; All authors contributed to the writing of the manuscript and approved its final version&#46;</p></span></span>"
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          "clase" => "keyword"
          "titulo" => "Keywords"
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          "palabras" => array:5 [
            0 => "Catch-up growth"
            1 => "Intrauterine growth restriction"
            2 => "Preterm infant"
            3 => "Very low birth weight infant"
            4 => "Growth pattern"
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          "clase" => "keyword"
          "titulo" => "Palabras clave"
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          "palabras" => array:5 [
            0 => "Crecimiento recuperador"
            1 => "Retraso de crecimiento intrauterino"
            2 => "Reci&#233;n nacido prematuro"
            3 => "Reci&#233;n nacido de muy bajo peso"
            4 => "Patr&#243;n de crecimiento"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The characteristics of catch-up growth in very low birth weight infants &#40;VLBW&#41; have not been clearly established&#46; The aim of this study was to analyse the height catch-up and some associated factors in a cohort of VLBW birth weight &#60;1&#44;500&#8239;g from birth to age 14 years&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">We obtained retrospective data on weight and height at birth and ages one&#44; 2&#44; 3&#44; 4&#44; 6&#44; 8&#44; 10&#44; 12 and 14 years in a cohort of 170 VLBW&#46; We compared these anthropometric values with those documented in a control group&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Thirty-seven children &#40;21&#46;8&#37;&#41; were born with an extremely low birth weight and 32 &#40;18&#46;8&#37;&#41; extremely preterm&#46; At 10 years of age&#44; 7&#37; of VLBW &#40;1&#44;000&#8211;1&#44;500&#8239;g&#41; and 35&#37; of extremely low birth weight &#60;1&#44;500&#8239;g children had short stature <span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;0&#46;001&#41;&#46; Almost all VLBW children who had a normal height at ages 2&#44; 4 and 10 years had exhibited adequate weight catch-up in previous evaluations&#46; We found that extremely low birth weight and extremely preterm were independent predictors for inadequate height catch-up&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The growth pattern of VLBW children has specific characteristics&#46; The catch-up in weight seems to be an important factor for catch-up in height&#44; and therefore a thorough nutritional follow-up is recommended in these children&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Las caracter&#237;sticas del crecimiento recuperador en ni&#241;os con muy bajo peso &#40;MBP&#41; al nacer no se han establecido con claridad&#46; El objetivo del estudio fue analizar el crecimiento recuperador de talla y factores asociados en una cohorte de ni&#241;os con MBP al nacer &#40;&#60; 1&#46;500 g&#41; desde el nacimiento hasta los 14 a&#241;os de edad&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Se recogieron datos retrospectivos de peso y talla a uno&#44; 2&#44; 3&#44; 4&#44; 6&#44; 8&#44; 10&#44; 12 y 14 a&#241;os de edad en una cohorte de 170 reci&#233;n nacidos con MBP&#46; Se compararon estos datos antropom&#233;tricos con los registrados en un grupo de control&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Treinta y siete ni&#241;os &#40;21&#46;8&#37;&#41; nacieron con extremado bajo peso y 32 &#40;18&#46;8&#37;&#41; fueron pret&#233;rmino extremo&#46; A los 10 a&#241;os de edad&#44; el 7&#37; de los ni&#241;os con MBP &#40;1&#46;000-1&#46;500&#8239;g&#41; y el 35&#37; de los ni&#241;os con extremado bajo peso &#60; 1&#46;500 g ten&#237;an talla baja p&#8239;&#61;&#8239;0&#44;001&#46; Casi todos los ni&#241;os con MBP que ten&#237;an una talla normal a los 2&#44; 4 y 10 a&#241;os de edad hab&#237;an alcanzado un peso adecuado en evaluaciones previas&#46; El extremado bajo peso al nacer y el nacimiento pret&#233;rmino extremo resultaron ser predictores independientes de un crecimiento recuperador de talla inadecuado&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">El patr&#243;n de crecimiento de ni&#241;os con MBP al nacer tiene unas caracter&#237;sticas espec&#237;ficas&#46; El crecimiento recuperador de peso parece ser un factor importante para el crecimiento recuperador de talla&#44; por lo que se recomienda un seguimiento nutricional cuidadoso en estos ni&#241;os&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Dur&#225;-Trav&#233; T&#44; et al&#46; Crecimiento recuperador y factores asociados en ni&#241;os de muy bajo peso al nacer&#46; An Pediatr &#40;Barc&#41;&#46; 2020&#59;93&#58;282&#8211;288&#46;</p>"
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      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
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          0 => array:3 [
            "identificador" => "at0015"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Percentages of complete catch-up growth in height in ELBW and VLBW infants &#40;chi square test&#41;&#46;</p>"
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      ]
      3 => array:8 [
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          0 => array:3 [
            "identificador" => "at0020"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">&#40;&#42;&#41; Student <span class="elsevierStyleItalic">t</span> test&#44; <span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;0&#46;05 in comparison of AGA and SGA&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">AGA&#44; appropriate for gestational age&#59; SGA&#44; small for gestational age&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Male</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Female</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AGA group&#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SGA group&#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AGA group&#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SGA group&#40;<span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gestational age&#42;&#40;weeks&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;7&#8239;&#177;&#8239;1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;3&#8239;&#177;&#8239;1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;9&#8239;&#177;&#8239;2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;6&#8239;&#177;&#8239;3&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weight &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1204&#46;3&#8239;&#177;&#8239;222&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1257&#46;4&#8239;&#177;&#8239;179&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1145&#46;8&#8239;&#177;&#8239;229&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1134&#46;0&#8239;&#177;&#8239;256&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Height &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;3&#8239;&#177;&#8239;3&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;0&#8239;&#177;&#8239;2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;2&#8239;&#177;&#8239;2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;4&#8239;&#177;&#8239;3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Gestational age&#44; birth weight and birth length of VLBW infants by sex &#40;mean&#8239;&#177;&#8239;SD&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">AGA&#44; appropriate for gestational age&#59; ELBW&#44; extremely low birth weight&#59; EPT&#44; extremely preterm&#59; LPT&#44; late preterm&#59; SGA&#44; small for gestational age&#59; VLBW&#58; very low birth weight&#59; VPT&#44; very preterm&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inadequate catch-up height gain</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age 2 yearsOR &#40;95&#37; CI&#41; <span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age 4 years OR &#40;95&#37; CI&#41; <span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age 10 years OR &#40;95&#37; CI&#41; <span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n
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                  \t\t\t\t">Birth weight</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>VLBW &#40;1000&#8722;1500&#8239;g&#41;&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ELBW &#40;&#60;1000&#8239;g&#41;&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;9 &#40;3&#46;3&#8211;24&#46;5&#41; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;9 &#40;3&#46;6&#8211;13&#46;6&#41; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;3 &#40;2&#46;1&#8211;13&#46;4&#41; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AGA group&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SGA group &#40;weight&#47;height&#41;&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6 &#40;0&#46;8&#8211;2&#46;9&#41; 0&#46;150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;5 &#40;0&#46;7&#8211;3&#46;1&#41; 0&#46;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;6 &#40;1&#46;1&#8211;6&#46;4&#41; 0&#46;038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AGA group&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SGA group &#40;only weight&#41;&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;4 &#40;0&#46;7&#8211;2&#46;7&#41; 0&#46;291&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;3 &#40;0&#46;6&#8211;2&#46;9&#41; 0&#46;457&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3 &#40;0&#46;9&#8211;5&#46;5&#41; 0&#46;069&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AGA group&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;69&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Reference group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SGA group &#40;only height&#41;&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;0 &#40;1&#46;3&#8211;1&#46;7&#41; 0&#46;048&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;9 &#40;1&#46;2&#8211;4&#46;0&#41; 0&#46;033&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#46;8 &#40;1&#46;1&#8211;6&#46;8&#41; 0&#46;024&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Single&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;98&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multiple&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;72&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;28 weeks &#40;EPT&#41;&#44; <span class="elsevierStyleItalic">n</span>&#8239;&#61;&#8239;72&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;9&#40;0&#46;7&#8211;5&#46;3&#41; 0&#46;242&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Logistic regression analysis of factors associated with inadequate catch-up growth&#46;</p>"
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                            0 => "T&#46;N&#46;K&#46; Raju"
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Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2019.06.007

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2020 September	115	27	142
2020 August	96	25	121
2020 July	87	24	111
2020 June	86	27	113
2020 May	93	23	116
2020 April	91	13	104
2020 March	78	15	93
2020 February	80	44	124
2020 January	6	4	10

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