Affiliation:
1. Eudowood Division of Pediatric Respiratory Sciences Johns Hopkins Medical Institutions Baltimore Maryland USA
2. Division of Pediatric Pulmonology Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
3. Division of General Pediatrics Johns Hopkins Medical Institutions Baltimore Maryland USA
Abstract
AbstractObjectivePreterm infants, and especially those with additional comorbidities, are at risk of early life growth failure, which may impact postnatal lung growth and attainment of peak lung function. However, little is known about the early life growth patterns of those with chronic lung disease. The goal of this study was to describe the patterns appreciated in this population and their association with certain clinical characteristics.Study DesignDemographic, clinical characteristics, and somatic growth parameters between birth and 3 years were retrospectively reviewed for a cohort of children (n = 616) recruited from an outpatient pulmonary clinic. Group‐based trajectory modeling was used to identify unique longitudinal trajectories for each growth parameter. Demographic and clinical characteristics were compared using nonparametric analysis.ResultsFour distinct trajectories were appreciated in all three somatic growth domains (weight, length, and weight‐for‐length), which demonstrated a sizable proportion of subjects with a z‐score below zero at 36 months of age, suggesting that the traditional preterm paradigm of “catch‐up” growth may not be accurate for this population.ConclusionsChildren with a history of chronic lung disease begin life with somatic growth measurements well below their term peers and display heterogeneous patterns of weight and length growth through the first 3 years of life. Future studies should focus on further understanding the relationship between somatic growth and respiratory outcomes in this population, which will ideally allow for the use of somatic growth measures as surrogate markers to identify individuals at the highest risk of postnatal growth failure and poor respiratory outcomes.
Subject
Pulmonary and Respiratory Medicine,Pediatrics, Perinatology and Child Health