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Arch Dis Child Fetal Neonatal Ed 2003;88:F492-F500 doi:10.1136/fn.88.6.F492
  • Original article

The EPICure study: growth and associated problems in children born at 25 weeks of gestational age or less

  1. N S Wood1,
  2. K Costeloe2,
  3. A T Gibson3,
  4. E M Hennessy2,
  5. N Marlow1,
  6. A R Wilkinson4,
  7. for the EPICure Study Group*
  1. 1School of Human Development, University of Nottingham, UK
  2. 2Queen Mary Westfield College, University of London, UK
  3. 3Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK
  4. 4Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to:
    Professor Marlow
    Academic Division of Child Health, Level E East Block, Queens Medical Centre, Nottingham NG7 2UH, UK; neil.marlownottingham.ac.uk
  • Accepted 2 December 2002

Abstract

Aim: To define growth outcomes of a geographically defined population of extremely preterm babies.

Population: The EPICure study identified all surviving children in the United Kingdom and Ireland born at ≤ 25 weeks 6 days gestation between March and December 1995. Of 308 survivors, 283 (92%) were evaluated at 30 months of age corrected for prematurity.

Methods: Growth was measured as part of a medical and full neurodevelopmental assessment. Growth parameters were evaluated in relation to other 30 month outcomes and perinatal variables.

Results: The children were smaller in each of the five growth measures compared with published population norms: mean (SD) standard deviation scores were −1.19 (1.32) for weight, −1.40 (1.37) for head circumference, −0.70 (1.19) for height, −1.00 (1.38) for body mass index, and −0.75 (0.95) for mid-upper arm circumference. Despite being of average size at birth, children were significantly lighter with smaller head circumferences at the expected date of delivery, compared with population norms, and only weight showed later catch up, by 0.5 SD. Poorer growth was found in children whose parents reported feeding problems and with longer duration of oxygen dependency, as a marker for neonatal respiratory illness. Although severe motor disability was associated with smaller head circumference, overall there was no relation between Bayley scores and head growth.

Conclusions: Poor growth in early childhood is common in extremely preterm children, particularly when prolonged courses of systemic steroids have been given for chronic lung disease. Improving early growth must be a priority for clinical care.

Footnotes

  • ↵* The EPICure Study Group comprises the paediatricians in 276 maternity units across the United Kingdom and Ireland who contributed data to the study, whose invaluable help we acknowledge. The steering group was responsible for overseeing the management of the study and the developmental panel performed the data collection and validation.

  • Funding: Serono Laboratories UK Ltd and BLISS.

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