Body Composition Changes in Preterm Infants Following Hospital Discharge: Comparison with Term Infants

Overview

Journal J Pediatr Gastroenterol Nutr

Publisher Wiley

Date 2011 May 24

PMID 21602717

Citations 33

Authors

Sara E Ramel

Heather L Gray

Katie L Ode

Noelle Younge

Michael K Georgieff

Ellen W Demerath

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Infants experiencing catch-up growth devote a greater proportion of their energy to fat deposition, potentially at the expense of gains in lean body mass. The objective of the present study was to compare the body composition of preterm and term infants after hospital discharge and to determine the effect of gestational age (GA), birth size, nutrition, and illness on growth in fat-free mass (FFM) after hospitalization.

Patients And Methods: Anthropometric measurements and body composition testing via air displacement plethysmography were performed on 26 appropriate-for-gestational-age (AGA) preterm (mean GA 31.5 ± 2.7 weeks) and 97 AGA term (mean GA 39.8 ± 1.0 weeks) infants at term corrected age (CA) and at 3 to 4 months CA.

Results: At term CA, preterm infants had lower FFM (3.0 vs 3.3 kg, P = 0.001), higher percentage of body fat (18.7% vs 15.2%, P < 0.0001), lower weight (P =0.04), and shorter length (P = 0.001) than term infants. By 3 to 4 months CA, weight, length, percentage of body fat, and FFM were similar in the 2 groups. GA, inpatient nutrition, and illness were associated with FFM at 4 months CA in the preterm infants (P < 0.05).

Conclusions: Markedly lower FFM and higher adiposity were observed in preterm infants at term CA, but these differences had lessened and were no longer statistically significant at 3 to 4 months CA. Although early nutrition was associated with growth trajectories in the hospital, the continuing influence of early illness on postdischarge growth suggests that nonnutritional factors (eg, disturbances in the growth hormone axis) also may affect body composition trajectories of preterm infants.

Citing Articles

High protein intake on later outcomes in preterm children: a systematic review and meta-analysis.

Das S, McClintock T, Cormack B, Bloomfield F, Harding J, Lin L Pediatr Res. 2024; 97(1):67-80.

PMID: 38858504 PMC: 11798874. DOI: 10.1038/s41390-024-03296-z.

Body composition after implementation of an enhanced parenteral nutrition protocol in the neonatal intensive care unit: a randomised pilot trial.

Nagel E, Super J, Marka N, Demerath E, Ramel S Ann Hum Biol. 2024; 51(1):2306352.

PMID: 38293997 PMC: 10964316. DOI: 10.1080/03014460.2024.2306352.

Maternal pregnancy-related anxiety and children's physical growth: the Ma'anshan birth cohort study.

Zhou J, Zhang S, Teng Y, Lu J, Guo Y, Yan S BMC Pregnancy Childbirth. 2023; 23(1):384.

PMID: 37231487 PMC: 10210302. DOI: 10.1186/s12884-023-05711-5.

Inflammation induces stunting by lowering bone mass via GH/IGF-1 inhibition in very preterm infants.

Cuestas E, Hillman M, Galetto S, Gaido M, Sobh V, Damico L Pediatr Res. 2023; 94(3):1136-1144.

PMID: 36941338 DOI: 10.1038/s41390-023-02559-5.

Preterm birth and metabolic implications on later life: A narrative review focused on body composition.

Casirati A, Somaschini A, Perrone M, Vandoni G, Sebastiani F, Montagna E Front Nutr. 2022; 9:978271.

PMID: 36185669 PMC: 9521164. DOI: 10.3389/fnut.2022.978271.

References

Catalano P, Farrell K, Thomas A, Huston-Presley L, Mencin P, de Mouzon S . Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr. 2009; 90(5):1303-13. PMC: 2762159. DOI: 10.3945/ajcn.2008.27416. View

Gardelis J, Hatzis T, Stamogiannou L, Dona A, Fotinou A, Brestas P . Activity of the growth hormone/insulin-like growth factor-I axis in critically ill children. J Pediatr Endocrinol Metab. 2005; 18(4):363-72. DOI: 10.1515/jpem.2005.18.4.363. View

Scheepens A, Moderscheim T, Gluckman P . The role of growth hormone in neural development. Horm Res. 2006; 64 Suppl 3:66-72. DOI: 10.1159/000089320. View

Johnson D, Guthrie D, Smyke A, Koga S, Fox N, Zeanah C . Growth and associations between auxology, caregiving environment, and cognition in socially deprived Romanian children randomized to foster vs ongoing institutional care. Arch Pediatr Adolesc Med. 2010; 164(6):507-16. PMC: 4126580. DOI: 10.1001/archpediatrics.2010.56. View

Finken M, Keijzer-Veen M, Dekker F, Frolich M, Hille E, Romijn J . Preterm birth and later insulin resistance: effects of birth weight and postnatal growth in a population based longitudinal study from birth into adult life. Diabetologia. 2006; 49(3):478-85. DOI: 10.1007/s00125-005-0118-y. View

Ong K, Ahmed M, Emmett P, Preece M, Dunger D . Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ. 2001; 320(7240):967-71. PMC: 27335. DOI: 10.1136/bmj.320.7240.967. View

Ibanez L, Ong K, Dunger D, de Zegher F . Early development of adiposity and insulin resistance after catch-up weight gain in small-for-gestational-age children. J Clin Endocrinol Metab. 2006; 91(6):2153-8. DOI: 10.1210/jc.2005-2778. View

Ellis K, Yao M, Shypailo R, Urlando A, Wong W, Heird W . Body-composition assessment in infancy: air-displacement plethysmography compared with a reference 4-compartment model. Am J Clin Nutr. 2007; 85(1):90-5. DOI: 10.1093/ajcn/85.1.90. View

Casimir M, de Andrade P, Gjinovci A, Montani J, Maechler P, Dulloo A . A role for pancreatic beta-cell secretory hyperresponsiveness in catch-up growth hyperinsulinemia: Relevance to thrifty catch-up fat phenotype and risks for type 2 diabetes. Nutr Metab (Lond). 2011; 8(1):2. PMC: 3033236. DOI: 10.1186/1743-7075-8-2. View

10.

Ehrenkranz R . Growth outcomes of very low-birth weight infants in the newborn intensive care unit. Clin Perinatol. 2000; 27(2):325-45. DOI: 10.1016/s0095-5108(05)70024-5. View

11.

Cooke R, Griffin I . Altered body composition in preterm infants at hospital discharge. Acta Paediatr. 2009; 98(8):1269-73. DOI: 10.1111/j.1651-2227.2009.01354.x. View

12.

Yeung M . Postnatal growth, neurodevelopment and altered adiposity after preterm birth--from a clinical nutrition perspective. Acta Paediatr. 2006; 95(8):909-17. DOI: 10.1080/08035250600724507. View

13.

Roggero P, Gianni M, Amato O, Orsi A, Piemontese P, Cosma B . Postnatal growth failure in preterm infants: recovery of growth and body composition after term. Early Hum Dev. 2008; 84(8):555-9. DOI: 10.1016/j.earlhumdev.2008.01.012. View

14.

Gianni M, Roggero P, Taroni F, Liotto N, Piemontese P, Mosca F . Adiposity in small for gestational age preterm infants assessed at term equivalent age. Arch Dis Child Fetal Neonatal Ed. 2009; 94(5):F368-72. DOI: 10.1136/adc.2008.153163. View

15.

Reichman B, Chessex P, Putet G, Verellen G, Smith J, Heim T . Diet, fat accretion, and growth in premature infants. N Engl J Med. 1981; 305(25):1495-500. DOI: 10.1056/NEJM198112173052503. View

16.

Urlando A, Dempster P, Aitkens S . A new air displacement plethysmograph for the measurement of body composition in infants. Pediatr Res. 2003; 53(3):486-92. DOI: 10.1203/01.PDR.0000049669.74793.E3. View

17.

Gillman M . The first months of life: a critical period for development of obesity. Am J Clin Nutr. 2008; 87(6):1587-9. PMC: 4407661. DOI: 10.1093/ajcn/87.6.1587. View

18.

Euser A, Finken M, Keijzer-Veen M, Hille E, Wit J, Dekker F . Associations between prenatal and infancy weight gain and BMI, fat mass, and fat distribution in young adulthood: a prospective cohort study in males and females born very preterm. Am J Clin Nutr. 2005; 81(2):480-7. DOI: 10.1093/ajcn.81.2.480. View

19.

Franz A, Pohlandt F, Bode H, Mihatsch W, Sander S, Kron M . Intrauterine, early neonatal, and postdischarge growth and neurodevelopmental outcome at 5.4 years in extremely preterm infants after intensive neonatal nutritional support. Pediatrics. 2009; 123(1):e101-9. DOI: 10.1542/peds.2008-1352. View

20.

Sewell M, Huston-Presley L, Super D, Catalano P . Increased neonatal fat mass, not lean body mass, is associated with maternal obesity. Am J Obstet Gynecol. 2006; 195(4):1100-3. DOI: 10.1016/j.ajog.2006.06.014. View