The Journal of pediatrics · 2026
Postnatal Growth Patterns in Children Born at Term and Preterm in a Large Primary Care Network.
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Lure Allison C, Verhagen Eleanor, Correa Emily Trudell, Vernacchio Louis, Hatoun Jonathan, Levin Jonathan, Rabbani Naveed
Аннотация
OBJECTIVE: To characterize longitudinal growth patterns in infants and toddlers by gestational age groups through 36 months of chronological age.
STUDY DESIGN: This is a retrospective cohort study of children seen in a Massachusetts statewide primary care network from 2017 to 2023, who had 5 or more growth measurements recorded, with at least 1 in the first 6 months of life. Growth measurements were converted to z-scores and analyzed at standardized well-child check intervals. Percentiles were calculated, and time to surpass the -2 z-score threshold was assessed.
RESULTS: A total of 60 966 unique children and 1 545 254 growth measurements were included in this study. Infants born preterm demonstrated lower z-scores across all growth metrics compared with term infants at birth, and these differences correlated with gestational age. Over time, the growth parameters of infants born preterm approximated those of full-term infants. Of infants born extremely preterm, <95% surpassed the -2 z-score for weight and height by 36 months, whereas 95% of infants born moderate and late preterm passed this threshold across all growth measurements by 24 months.
CONCLUSIONS: Infant and toddler growth varied by gestational age over the first 3 years, with infants born at the most immature gestational ages showing incomplete catch-up growth. Our findings support accounting for gestational age through 36 months for infants born at <32 weeks of gestation and through 24 months for those born at 32-37 weeks of gestation. These insights may inform updates to growth monitoring guidelines.
STUDY DESIGN: This is a retrospective cohort study of children seen in a Massachusetts statewide primary care network from 2017 to 2023, who had 5 or more growth measurements recorded, with at least 1 in the first 6 months of life. Growth measurements were converted to z-scores and analyzed at standardized well-child check intervals. Percentiles were calculated, and time to surpass the -2 z-score threshold was assessed.
RESULTS: A total of 60 966 unique children and 1 545 254 growth measurements were included in this study. Infants born preterm demonstrated lower z-scores across all growth metrics compared with term infants at birth, and these differences correlated with gestational age. Over time, the growth parameters of infants born preterm approximated those of full-term infants. Of infants born extremely preterm, <95% surpassed the -2 z-score for weight and height by 36 months, whereas 95% of infants born moderate and late preterm passed this threshold across all growth measurements by 24 months.
CONCLUSIONS: Infant and toddler growth varied by gestational age over the first 3 years, with infants born at the most immature gestational ages showing incomplete catch-up growth. Our findings support accounting for gestational age through 36 months for infants born at <32 weeks of gestation and through 24 months for those born at 32-37 weeks of gestation. These insights may inform updates to growth monitoring guidelines.