GROWTH OF PHENYLKETONURIC (PKU) CHILDREN UP TO TWO YEARS
Giovannini M, Fiori L, Verduci E, Fiege B, Colombo L, Gianni’ ML,
Scaglioni S
Department of Pediatrics, San Paolo Hospital,
I-20142 Milan, Italy
Background: The semisynthetic diet for PKU children
after diagnosis may be limited in some essential nutrients and may
influence absorption.
Aim: To check the growth indices of treated
PKU children in the first two years of life.
Subjects and
methods: 25 term PKU
infants followed in our Department in the 1994-1998 period. Comparison with
reference groups of either formula-fed (FF, n=65) or breastfed (BF, n=73)
healthy term infants through z-scores of the World Health Organization.
Statistical analysis with non-parametric tests.
Results: Considering treated PKU infants as an
artificially-fed population from very early ages, we have compared them
with the FF reference group. PKU showed lower (P<0.05) z-scores for
weight at 3, 4, 6, 9, 12, 18 and 24 months and for length at 18 and 24
months. We have then compared the growth indices of PKU exclusively
breastfed up to diagnosis (n= 11) with those of BF infants to eliminante
any environmental bias. PKU subjects (tendencially lighter at birth,
P=0.12) showed lower z-scores for weight at 1, 2, 3, 4, 6, 12, 18 and 24
months and lower z-scores for length at 3 months. Conclusions: The
dietary treatment of PKU subjects is associated with depressed growth
indices in the first 24 months of life. Even considering those initially
breastfed, their growth is limited compared to a reference BF group. Since
the nutrient supply and growth rate of healthy BF infants is
characteristically limited compared to those of healthy FF counterparts,
our findings show that well-controlled PKU infants have lower growth
indices (particularly for weight) in the first 24 months of life. The
dietary treatment may be a major cause, but the trend of a weight
difference already present at birth generates the hypothesis of some
negative influences on fetal growth in utero.