Abstract:
BACKGROUND : Preterm infants often have poor short- and long-term growth. Kangaroo
mother care supports short-term growth, but longer-term outcomes are unclear.
METHODS : This study analysed longitudinally collected routine clinical data from a
South African cohort of preterm infants (born <37 weeks gestation) attending the
outpatient follow-up clinic of a tertiary-level hospital (Tshwane District, South Africa)
for 1 year between 2012 and 2019. At 1 year, small-for-gestational age (SGA) and
appropriate-for-gestational age (AGA) infants were compared with regard to agecorrected
anthropometric z-scores (weight-for-age [WAZ], length-for-age [LAZ],
weight-for-length [WLZ] and BMI-for-age [BMIZ]) and rates of underweight
(WAZ < 2), stunting (LAZ < 2), wasting (WLZ < 2) and overweight (BMIZ> + 2).
Multiple regression analysis was used to investigate associations between maternal/infant
characteristics and rates of underweight, stunting, wasting and overweight.
RESULTS : At 1 year, compared with AGA infants (n = 210), SGA infants (n = 111)
had lower WAZ (1.26 ± 1.32 vs. 0.22 ± 1.24, p < 0.001), LAZ (1.50 ± 1.11
vs. 0.60 ± 1.06, p < 0.001), WLZ (0.66 ± 1.31 vs. 0.11 ± 1.24, p < 0.001) and BMIZ
(0.55 ± 1.31 vs. 1.06 ± 1.23, p < 0.001), despite larger WAZ gains from birth
(+0.70 ± 1.30 vs. +0.05 ± 1.30, p < 0.001). SGA infants had significantly more
stunting (34.2% vs. 9.1%; p < 0.001), underweight (31.2% vs. 7.2%; p < 0.001)
and wasting (12.6% vs. 4.3%, p = 0.012), with no difference in overweight
(4.5% vs. 7.7%, p = 0.397). In multiple regression analysis, birth weight-for-GA
z-score more consistently predicted 1-year malnutrition than SGA.
CONCLUSION : Preterm-born SGA infants remain more underweight, stunted and wasted
than their preterm-born AGA peers at 1 year, despite greater WAZ gains. Interventions
for appropriate catch-up growth especially for SGA preterm infants are needed.
