Background In preterm hypertensive disorders of pregnancy, fetal growth restriction (FGR) occurs frequently. The timing and severity of FGR impacts childhood growth and is associated with metabolic changes later in life.

Aim To examine growth and the impact of FGR in early childhood.

Design Prospective cohort study.

Participants Children (n=135) born to mothers who were admitted before 34 weeks’ gestational age with a severe hypertensive disorder of pregnancy.

Outcome measures Height, weight, body mass index (BMI), head circumference (HC), SD scores (SDS) at 3 months, and 1 and 4.5 years of age, and complete catch-up growth (height SDS−target height SDS >−1.6).

Results Growth scores were lower compared to Dutch growth curves, except for BMI at 3 months and girls’ HC at all ages. Mean height SDS increased over time from −1.4 to −0.5 at 4.5 years, with 94% having complete catch-up growth. Mean BMI SDS decreased from −0.2 at 3 months to −1.0 at 1 year, and was −0.8 at age 4.5. Mean HC SDS was stable over time and −0.3 at 4.5 years. The customised birth weight ratio, as a measure of the degree of FGR, was related to all growth SDS at 4.5 years, while gestational age at birth was not.

Conclusions Although the majority of children born growth restricted had catch-up growth of height within the normal range at 4.5 years of age, they were smaller, but especially lighter compared to Dutch growth charts. The degree of FGR was associated with all growth outcomes.