Table 3 Summary of Results: Associations between Prenatal Growth, Postnatal Growth, and Indicators of Obesitya

From: Relationship between prenatal growth, postnatal growth and childhood obesity: a review

 

BMI or BMI z-score

Odds of overweight or obesity

Waist circumference

Fat mass or fat mass index

Fat-free mass orfat-free mass index

% body fat or fat mass

Relative fat mass

Central to total ratio or central fat ratio b

Waist to height ratio

Waist-to-hip ratio or android/gynoid fat ratio

Sum of skinfold thickness c

subscapular to triceps skinfold thickness ratio d

Ratio of preperitoneal to subcutaneous distance e

Central fat mass f

Peripheral fat mass f

Study

Prenatal growth

 BW

+

 

+

NS

  

+

        

(33)

  

NR

             

(42)

  

+h

             

(46)

 

NR

 

NR

            

(38)

 

NR

 

NR

NR

NR

          

(31)

 

NR

 

NR

NR

NR

NR

    

NR

    

(35)

      

−

 

−

  

−

    

(39)

 

+Boys only

 

+Boys only

NS

+Boys only

−Girls only

         

(34)

 

NR

NR

        

NR

    

(48)

             

NR

  

(32)

 

NR

NR

             

(40)

  

NR

             

(45)

 BMI

+

 

+

+

+

+

 

NS

+

      

(37)

 

+

+

             

(41)

 Size for gestational age

NR

  

NR

 

NR

   

NR

 

NR

   

(43)

 

NR

NR

        

NR

  

NR

NR

(47)

 

NR

  

NR

NR

    

NR

     

(36)

 IUGR

 

NR

             

(44)

Postnatal growth

 Δ weight

 

+

             

(45)

  

+

             

(46)

 

+

 

+

+

+

+

         

(34)

 

+

 

+

+

+

          

(31)

 

+

 

+

+

+

 

+

        

(33)i

 

+

 

+

+

+

+

    

NS

    

(35)

      

+

 

+

  

+

    

(39)

 

+

+

             

(40)i

 

+g

+g

        

+g

    

(48)

             

NR

  

(32)

 

NR

NR

        

NR

  

NR

NR

(47)

 

NR

  

NR

NR

    

NR

     

(36)

 

NR

 

NR

            

(38)

 

NR

 

NR

NR

 

NR

   

NR

 

NR

   

(43)

  

NR

             

(44)

 BMI

+

 

+

+

+

+

 

+

+

      

(37)

 

+

+

             

(41)

  

NR

             

(42)

Interaction: Prenatal × Postnatal

 BW s.d. score × Δ weight s.d. score

NS

 

NS

NS

NS

          

(31)j

 BW × catch- up growthk

            

–, NSl

  

(32)

 BW (kg) × weight

NS

 

NS

NS

NS

 

NS

        

(33)j

 

NS

 

NS

NS

NS

NS

         

(34)s

 

NS

 

NS

NS

NS

NS

    

NS

    

(35)j

      

− P=0.76t

 

− P=0.06u

  

NS

    

(39)

  

P>0.10

             

(45)j

  

P=0.50

             

(46)j

 Size for gestational age × presence of catch- up growthk

SGA: NS

AGA: +

LGA: +v

  

SGA: +, NS

AGA: +

LGA: +w

SGA:−, NS

AGA: −

LGA: −x

    

SGA: +

AGA: +

LGA: +, NSy

     

(36)

 

SGA: NS

LGA: +m

 

SGA: NS

LGA: +n

SGA: NS

LGA: +o

 

SGA: NS

LGA: NSp

   

SGA: NS

LGA: NSq

 

SGA: +

LGA:NSr

   

(43)

 

SGA: −

AGA: +

LGA: +z

SGA: NS

AGA: +

LGA: +aa

        

SGA: NS

AGA: +

LGA: +ab

  

SGA: NS

AGA: +

LGA: +ac

SGA: NS

AGA: +

LGA: +ad

(47)

 BMI × BMI

NS

 

NS

NS

NS

NS

 

NS

NS

      

(37)j

 

− P<0.01ae

− P<0.05af

             

(41)

 BW × rapid growth

LBW: +, NS

ABW: +, NSag

 

LBW: +, NS

ABW: +ah

            

(38)

 

+P=0.01ai

+aj

             

(40)

 BW × BMI

 

P=0.78

             

(42)j

 IUGR × Rapid growthak

 

OW: IUGR: NS; non−IUGR: +

Obesity: IUGR: NS; non−IUGR: NSal

OW: P=0.42

Obesity: P=0.33

             

(44)

 WFL × WFL

 

P=0.92

        

NR

    

(48)

  1. Abbreviations: AGA, appropriate for gestational age; BMI, body mass index; BW, birthweight; CUG, catch-up growth; FM, fat mass; FMI, fat mass index (kg/m2); FFM, fat-free mass; FFMI, fat-free mass index (kg/m2); g, grams; IUGR, intrauterine growth restricted; kg, kilograms; LGA, large for gestational age; mos, months; OW, overweight; RG, rapid growth; s.d., standard deviation; SFT, skinfold thickness; SGA, small for gestational age; STR, subscapular to triceps skinfold thickness ratio; PP/SC-distance, preperitoneal to subcutaneous distance; WC, waist circumference; WFL, weight-for-length; WHR, waist-to-hip ratio; wks, weeks; Δ, change.
  2. This table presents a summary of results from all articles included in this review that assessed the independent effect of prenatal growth, while accounting for the effect of postnatal growth, the independent effect of postnatal growth, while accounting for the effect of prenatal growth, and the interaction between prenatal growth and postnatal growth. Symbols indicate the sign and significance of associations with each obesity- related outcome: significant positive association (+), significant negative association (−), and nonsignificant association (NS). Blanks cells indicate the association was not assessed.
  3. bThe central fat ratio refers to a ratio of the sum of suprailliacal and subscapular SFT to the sum of triceps and biceps SFT.
  4. cThe sum of four SFT refers to the sum of biceps, triceps, suprailliacal and subscapular skinfold thicknesses.
  5. dThe subscapular to triceps skinfold thickness ratio (STR) is used to assess regional differences in subcutaneous fat distribution, with a higher ratio representing increased central fat deposition.
  6. eThe ratio of preperitoneal to subcutaneous distance (PP/SC-distance) refers to the ratio between preperitoneal fat thickness and subcutaneous thickness, with a higher ratio representing a more adverse distribution of abdominal fat.
  7. fCentral fat mass refers to the sum of suprailliacal and subscapular SFT. Peripheral fat mass refers to the sum of triceps and biceps SFT.
  8. gResults were not significant for quartile 2 of postnatal growth with any outcomes but were positive for quartiles 3 and 4 with all outcomes.
  9. hThis association became nonsignificant after adjusted for breastfeeding and weight at 1 year.
  10. iThese studies used multiple postnatal growth measurements.
  11. jSign and/or P-value of interaction term not reported.
  12. kIncrease in weight s.d. score >0.67.
  13. lWithin each BW tertile, CUG not significantly associated with adverse abdominal fat distribution (compared with 2nd tertile BW, normal growth): 1st tertile BW −4.40 (−15.89, 8.76); 2nd tertile BW: −12.10 (−25.40, 3.56); 3rd tertile BW −4.78 (−36.17, 42.05), P trend=0.02.
  14. mSGA with CUG no significant difference in BMI compared with AGA with normal growth −0.2 (−0.4, −0.1); LGA with continued growth had significantly increased BMI (0.8 (0.4, 1.1)).
  15. nSGA with CUG no significant difference in WC compared with AGA with normal growth (−0.3 (−0.9, 0.3)); LGA with continued growth significantly increased WC compared with AGA with normal growth (1.9 (1.1, 2.8)).
  16. oSGA with CUG no significant difference in FMI compared with AGA with normal growth (−0.1 (−0.3, 0.05)); LGA with continued growth significantly increased FMI compared with AGA with normal growth (0.2 (0.01, 0.50)).
  17. pSGA with CUG no significant difference in % body fat compared with AGA with normal growth (−0.2 (−0.9, 0.4)); LGA with continued growth no significant difference in % body fat compared with AGA with normal growth (0.5 (−0.4, 1.5)).
  18. qSGA with CUG no significant difference in WHR compared to AGA with normal growth (0.003 (−0.001, 0.007)); AGA with continued growth no significant difference in WHR compared to AGA with normal growth (0.005 (−0.001, 0.011)).
  19. rSGA with CUG significantly increased S:T ratio compared with AGA with normal growth (0.002 (0.003, 0.04)); LGA with continued growth had no significant difference in S:T ratio compared with AGA with normal growth (−0.02 (−0.04, 0.01)).
  20. sP>0.29 for all tests of interaction.
  21. t6 wks: b=−6.18 × 105, P=0.76; 6 mos: b=0.00, P=0.13.
  22. u−7.38 × 10–6, P=0.059: postnatal weight gain has a larger effect on fat distribution for lower BW compared with higher BW.
  23. vSGA with CUG no significant difference in BMI compared with AGA with normal growth (0.00 (−0.11, 0.11)); AGA with CUG and LGA with CUG had significantly increased BMI (AGA: 0.55 (0.45, 0.59); LGA: 1.11 (0.64, 1.58)).
  24. wSGA with CUG had nonsignificant increase in FMI compared with AGA with normal growth (0.09 (−0.02, 0.20)); AGA with CUG and LGA with CUG had significantly increased FMI (AGA: 0.31 (0.24, 0.38); LGA: 0.73 (0.26, 1.19)).
  25. xSGA with CUG had nonsignificant decrease in FFMI compared with AGA with normal growth (−0.04 (−0.11, 0.02)); AGA with CUG and LGA with CUG had significant decreased FFMI (AGA: −0.16 (−0.20, −0.12); LGA: −0.30 (−0.56, −0.03)).
  26. ySGA with CUG had significant increase in android/gynoid fat ratio compared with AGA with normal growth (0.22 (0.09, 0.35)); AGA with CUG had significant increase in android/gynoid fat ratio (0.26 (0.18, 0.34)) while LGA with CUG had a nonsignificant increase in android/gynoid fat ratio (0.44 (−0.11, 0.99)).
  27. zComparison group=AGA with normal growth: SGA with CUG significantly lower BMI s.d. score (−0.23 (−0.39, −0.07)); AGA with CUG significantly higher BMI (0.44 (0.37, 0.52)) LGA with continued growth significantly higher BMI (1.06 (0.77, 1.36)).
  28. Comparison group=AGA with normal growth: SGA with CUG no significant difference (0.92 (0.43, 1.96)); AGA with CUG significantly higher odds OW/obesity (3.11 (2.37, 4.08)); LGA with continued growth significantly higher odds OW/obesity (12.46 (6.07, 25.58)).
  29. Comparison group=AGA with normal growth: SGA with CUG no significant difference (−0.26 (−3.22, 2.70)); AGA with CUG significantly higher SFT (3.50 (2.02, 4.97)); LGA with continued growth significantly higher SFT (8.95 (3.93, 13.97)).
  30. Comparison group=AGA with normal growth: SGA with CUG no significant difference (−0.11 (−1.52, 1.30)); AGA with CUG significantly higher central FM (1.95 (1.25, 2.76)); LGA with continued growth significantly higher central FM (4.42 (2.02, 6.81)).
  31. Comparison group=AGA with normal growth: SGA with CUG no significant difference (−0.15 (−2.11, 1.80)); AGA with CUG significantly higher peripheral FM (1.47 (0.51, 2.44)); LGA with continued growth significantly higher peripheral FM (4.55 (1.24, 7.87)).
  32. Interaction term: b=−0.15 (−0.25, −0.05), P<0.01.
  33. Interaction term: OR=0.63 (0.44, 0.90), P<0.05.
  34. No significant differences in mean BMI were observed for LBW with rapid growth (mean=15.6, s.d.=2.3), compared with LBW without rapid growth (mean=14.5, s.d.=1.2), compared with ABW without rapid growth (mean=15.7, s.d.=2.0), or compared with ABW with rapid growth (mean=17.4, s.d.=3.0).
  35. No significant differences in mean WC were observed for LBW with rapid growth (mean=57.8, s.d.=5.6) compared with LBW without rapid growth mean=54.1, s.d.=3.3), compared with ABW without rapid growth (mean=57.8, s.d.=5.3) or compared with ABW with rapid growth (mean=62.5, s.d.=7.6).
  36. Interaction term P-values: boys and girls: P=0.001; boys: P=0.02; girls: P=0.03.
  37. Odds of OW (ORs, 95% CI) for boys with accelerated growth by BW tertile: low 2.50 (1.71, 3.66); med 3.98 (2.62, 6.05); high 4.97 (3.16, 7.83); odds of OW (ORs, 95% CI) for girls with accelerated growth by BW tertile: low 1.12 (0.73, 1.72); med 1.96 (1.22, 3.15), high 3.32 (1.85, 5.95).
  38. Increase in weight-for-age z-score >0.67.
  39. Odds OW IUGR with RG: 2.46 (0.70, 8.65); odds OW non-IUGR with RG: 1.63 (1.10, 2.43); odds obesity IUGR with RG: 2.69 (0.22, 32.51); odds obesity non-IUGR with RG: 1.79 (0.97, 3.30).
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