Abstract
Background:
Premature birth is associated with increased adipose deposition after birth. Standard anthropometry (body weight, length, and head circumference) may not adequately assess fat deposition. Validated methods to assess adiposity are needed to optimize growth quality in preterm infants. The purpose of this study was to identify covariates of infant body fat.
Methods:
Air displacement plethysmography (ADP), standard anthropometry, and body circumferences were measured at hospital discharge in preterm (n = 28; 31–35 wk postmenstrual age (PMA)) and term (n = 28; 38–41 wks PMA) infants.
Results:
Body weight, length, and head circumference were lower for preterm infants (P < 0.05) at hospital discharge compared with that of term infants. Despite smaller body size and younger PMA, preterm infant percent body fat (%BF) by ADP was 12.33 ± 4.15% vs. 9.64 ± 4.01% in term infants (P = 0.01). Mid-arm circumference (MAC) is a covariate of %BF in both preterm and term infants (adjusted R2 = 0.49; P < 0.001). In preterm infants alone, MAC accounted for 60.4% of the variability of percent body fat (%BF) by ADP (P < 0.01).
Conclusions:
Preterm infants have increased body fat deposition as they approach term-corrected age, and MAC is a reliable, low-cost measure for monitoring infant body fat deposition in preterm and term infants.
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References
Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of near-term infants. Pediatrics 2004;114:372–6.
Centers for Disease Control and Prevention. National Prematurity Awareness Month, What is Premature Birth? 2014. (http://www.cdc.gov/features/prematurebirth/.)
Sauer PJ. Can extrauterine growth approximate intrauterine growth? Should it? Am J Clin Nutr 2007;85:608S–13S.
McLeod G, Sherriff J. Preventing postnatal growth failure–the significance of feeding when the preterm infant is clinically stable. Early Hum Dev 2007;83:659–65.
Roggero P, Giannì ML, Amato O, et al. Is term newborn body composition being achieved postnatally in preterm infants? Early Hum Dev 2009;85:349–52.
Roggero P, Giannì ML, Amato O, et al. Influence of protein and energy intakes on body composition of formula-fed preterm infants after term. J Pediatr Gastroenterol Nutr 2008;47:375–8.
Uthaya S, Thomas EL, Hamilton G, Doré CJ, Bell J, Modi N. Altered adiposity after extremely preterm birth. Pediatr Res 2005;57:211–5.
Cooke RJ, Rawlings DJ, McCormick K, et al. Body composition of preterm infants during infancy. Arch Dis Child Fetal Neonatal Ed 1999;80:F188–91.
Giannì ML, Roggero P, Liotto N, et al. Postnatal catch-up fat after late preterm birth. Pediatr Res 2012;72:637–40.
Levitt NS, Lambert EV, Woods D, Hales CN, Andrew R, Seckl JR. Impaired glucose tolerance and elevated blood pressure in low birth weight, nonobese, young south african adults: early programming of cortisol axis. J Clin Endocrinol Metab 2000;85:4611–8.
Kapoor A, Dunn E, Kostaki A, Andrews MH, Matthews SG. Fetal programming of hypothalamo-pituitary-adrenal function: prenatal stress and glucocorticoids. J Physiol 2006;572(Pt 1):31–44.
Hales CN, Ozanne SE. For debate: fetal and early postnatal growth restriction lead to diabetes, the metabolic syndrome and renal failure. Diabetologia 2003;46:1013–9.
Ramel SE, Gray HL, Davern BA, Demerath EW. Body composition at birth in preterm infants between 30 and 36 weeks gestation. Pediatr Obes 2015;10:45–51.
Antonini SR, Jorge SM, Moreira AC. The emergence of salivary cortisol circadian rhythm and its relationship to sleep activity in preterm infants. Clin Endocrinol (Oxf) 2000;52:423–6.
Giannì ML, 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:F368–72.
Koo WW, Hockman EM. Posthospital discharge feeding for preterm infants: effects of standard compared with enriched milk formula on growth, bone mass, and body composition. Am J Clin Nutr 2006;84:1357–64.
Centers for Disease Control and Prevention. Growth Charts, 2010. (http://www.cdc.gov/growthcharts/.)
Neu M, Goldstein M, Gao D, Laudenslager ML. Salivary cortisol in preterm infants: validation of a simple method for collecting saliva for cortisol determination. Early Hum Dev 2007;83:47–54.
Hazinski MF. Nursing Care of the Critically Ill Child. 3rd edn. St Louis, MO: CV Mosby, 2013:235.
Munro BH. Statistical Methods for Health Care Research. 5th edn. Philadelphia, PA: Lippincott Williams & Wilkins, 2004:512.
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The authors thank Kimberly Neff and Karen Wheeler for their assistance with infant measurements and data entry.
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Daly-Wolfe, K., Jordan, K., Slater, H. et al. Mid-arm circumference is a reliable method to estimate adiposity in preterm and term infants. Pediatr Res 78, 336–341 (2015). https://doi.org/10.1038/pr.2015.103
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DOI: https://doi.org/10.1038/pr.2015.103
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