Objective To explore associations between growth retardation and perinatal factors in preterm infants. Methods Length data of 3 228 measurements from 1 313 preterm infants aged under 2 years of age were retrospectively collected from the Child Health Management System of the Department of Pediatrics, Renmin Hospital of Wuhan University, between January 2018 and December 2025. Length was compared across groups stratified by perinatal factors. Associations between perinatal factors and growth retardation were analyzed. Results Significant differences in length were found among subgroups stratified by sex, gestational age, birth weight, and weight-for-gestational age (P<0.05). The prevalence of growth retardation was 29.77% (961/3 228). Stepwise multivariable logistic regression identified gestational age ≥ 32 weeks, birth weight ≥ 1 000 g, female sex, history of mild birth asphyxia, and maternal age at delivery ≥ 35 years as independent protective factors against growth retardation (P<0.05). Conclusions Growth retardation in preterm infants is influenced by multiple perinatal factors, such as gestational age, birth weight, sex, and maternal age at delivery. Individualized management strategies should be developed for preterm infants.