Wachstum frühgeborener Kinder bis zum Vorschulalter

Advances in Neonatology lead to more surviving preterm children with a birthwight < 1500g in the last 20 years. But studies following up the development of preterm children up to preschool age are rare. Participating children of this study were survivors of a group of 92 children with a birthweight < 1500g treated postnatal in the Marburg University Children Hospital between 01.01.1993 and 01.06.1995. Of the 81 surviving children 58 took part and they were 5 or 6 years old at follow-up. 19 of these children had a birthweight < 1000g, 39 weighed 1000-1500g at birth. 10 children were small for gestational age (SGA). A group of 67 term children from local kindergardens took part in auxological measurements as control. Results: The deficits in lenght and weight of preterm children existing at birth had increased up to demission, but were nearly compensated up to follow-up. At preschool age mean z-scores for lenght and weight of preterm children were just slightly below mean values of the control group, and the difference to the mean values was lower as the corresponding z-scores at birth. But headcircumference of preterm children, which increased slowly between birth and demission, did not even reach the z-score of birth at follow-up. Preterm boys had obviously lower z-scores for headcircumference, tended to were lighter and had lower BMI compared to preterm girls. Term children were significantly heavier and had higher BMI than preterm children. Preterm children with a birthweight < 1000g could not compensate preexisting deficits in growth up to preschool age and were especially lighter than control children. In contrast preterm children with a birthweight of 1000-1500g had normal values for lenght, height and headcircumference at preschool age, and z-scores in all three categories were higher than those of preterm children with birthweight < 1000g. There were no differences in growth between SGA- and AGA-preterm children at preschool age. At preschool age preterm children who had received less than 70 kcal/kg/d were obviously smaller than those who had received more than 70 kcal/kg/d. Deviations from z-scores of midparental height were more frequent in preterm children with birthweight < 1000g. Analysis of the growth factors IGF1, IGF-BP3 and Leptin as well as other values like TSH, T4, T3, CRP, GOT, GPT, Creatinine, AP and Ferritine could not detect any conspicuity nor differences between boys and girls nor between VLBW- and ELBW-preterm children. At preschool age bone age of preterm children corresponded with chronological age in most cases. Compared to previous studies this study demonstrates a positive trend in development, especially in lenght, for preterm children with a birthweight < 1500g. Relevant differences in growth between preterm boys and girls at preschool age had not been reported yet.