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The EPICure study: growth and blood pressure at 6 years of age following extremely preterm birth

¹ School of Human Development, University of Nottingham, UK
² The Wolfson Institute, Queen Mary’s School of Medicine and Dentistry, University of London, UK
³ University of Warwick, Department of Psychology and Warwick Medical School, UK

Correspondence to:
Professor N Marlow, Academic Division of Child Health, Level E East Block, Queens Medical Centre, Nottingham NG7 2UH, UK; neil.marlow{at}nottingham.ac.uk

Background: Preterm children are at risk for reduced growth in early childhood, which may predispose them to later changes in blood pressure (BP).

Objective: To study growth and BP in extremely preterm (EP) children at age 6 years.

Methods: Children who were born at 25 completed weeks of gestation or less in the United Kingdom and Ireland in 1995 were evaluated when they reached early school age. Children underwent standardised assessments, including auxology and sitting BP.

Results: Of 308 surviving children, 241 (78%) were assessed at a median age of 6 years 4 months; 160 full-term classmates acted as a comparison group. Compared with classmates, EP children were 1.2 standard deviations (SDs) lighter, 0.97 SD shorter, body mass index (BMI) was 0.95 SD lower and head circumference 1.3 SD lower. Compared with 2.5 years of age, EP children had shown "catch-up" in their weight by 0.37 SD, height by 0.42 SD and head circumference by 0.13 SD. Systolic and diastolic BP were lower by 2.3 mm Hg and 2.4 mm Hg, respectively, in EP children, but these differences were accounted for by differences in height and BMI. Maternal smoking in pregnancy was associated with lower BP. Children born before 24 weeks had higher systolic pressures and children given postnatal steroids higher diastolic pressures.

Conclusions: Poor postnatal growth seen after birth and in the third year persists into school age. Catch-up growth reduces some of the early deficit but is least for head growth. Despite serious postnatal growth restriction BP appears similar in both EP and term classmates.