Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Association between body composition at term equivalent age and Bayley scores at 2 years in preterm infants

Abstract

Objective

To evaluate whether in a historical cohort of preterm infants, body composition at term equivalent age (TEA) correlated with Bayley scores at 2 years of corrected age.

Study design

Ninety-five preterm babies were admitted to our neonatal intensive unit and underwent air-displacement plethysmography assessment at TEA. Of these, 74 completed Bayley tests at 2 years. We used multiple linear regression analysis to assess the association of body composition with Bayley scores.

Results

Mean gestational age and birthweight of our population were respectively 29.8 (±2.2) weeks and 1150 (±330) grams. Higher fat-free mass (FFM) z-score was associated with higher language (adjusted r = 0.28, p = 0.03) and motor composite scores (adjusted r = 0.33, p = 0.03) in both univariate and multiple regression analysis including birth weight, sex, maternal university degree, mechanical ventilation, and bilingualism.

Conclusions

In our study FFM at term equivalent age was associated with higher Bayley composite motor and language scores at 2 years.

This is a preview of subscription content, access via your institution

Access options

Buy this article

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Johnson MJ, Wootton SA, Leaf AA, Jackson AA. Preterm birth and body composition at term equivalent age: a systematic review and meta-analysis. Pediatrics. 2012;130:e640–9.

    Article  Google Scholar 

  2. Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics. 2006;117:1253–61.

    Article  Google Scholar 

  3. Ramel SE, Gray HL, Christiansen E, Boys C, Georgieff MK, Demerath EW. Greater early gains in fat-free mass, but not fat mass, are associated with improved neurodevelopment at 1 year corrected age for prematurity in very low birth weight preterm infants. J Pediatr. 2016;173:108–15.

    Article  Google Scholar 

  4. Pfister KM, Zhang L, Miller NC, Ingolfsland EC, Demerath EW, Ramel SE. Early body composition changes are associated with neurodevelopmental and metabolic outcomes at 4 years of age in very preterm infants. Pediatr Res. 2018;84:713–8.

    Article  Google Scholar 

  5. Scheurer JM, Zhang L, Plummer EA, Hultgren SA, Demerath EW, Ramel SE. Body composition changes from infancy to 4 Years and associations with early childhood cognition in preterm and full-term children. Neonatology. 2018;114:169–76.

    Article  Google Scholar 

  6. Frondas-Chauty A, Simon L, Flamant C, Hanf M, Darmaun D, Rozé JC. Deficit of Fat Free Mass inVery Preterm Infants at Discharge is Associated with neurological Impairment at Age 2 Years. J Pediatr. 2018;196:301–4.

    Article  Google Scholar 

  7. Ramel SE, Haapala J, Super J, Boys C, Demerath EW. Nutrition, illness and body composition in very low birth weight preterm infants: implications for nutritional management and neurocognitive outcomes. Nutrients. 2020;12:145.

    Article  Google Scholar 

  8. Paviotti G, De Cunto A, Zennaro F, Boz G, Travan L, Cont G, et al. Higher growth, fat and fat-free masses correlate with larger cerebellar volumes in preterm infants at term. Acta Paediatr. 2017;106:918–25.

    Article  CAS  Google Scholar 

  9. Urlando A, Dempster P, Aitkens S. A new air displacement plethysmograph for the measurement of body composition in infants. Pediatr Res. 2003;53:486–92.

    Article  Google Scholar 

  10. Bertino E, Spada E, Occhi L, Coscia A, Giuliani F, Gagliardi L, et al. Neonatal anthropometric charts: the Italian neonatal study compared with other European studies. J Pediatr Gastroenterol Nutr. 2010;51:353–61.

    Article  Google Scholar 

  11. Norris T, Ramel S, Catalano P, Caoimh C, Roggero P, Murray D, et al. New charts for the assessment of body composition, according to air-displacement plethysmography, at birth and across the first 6 mo of life. Am J Clin Nutr. 2019;109:1353–60.

    Article  Google Scholar 

  12. Shim SY, Ahn HM, Cho SJ, Park EU. Early aggressive nutrition enhances language development in very low-birthweight infants. Pediatrics Int. 2014;56:845–50.

    Article  CAS  Google Scholar 

  13. Simon L, Théveniaut C, Flamant C, Frondas-Chauty A, Darmaun D, Rozé JC. In preterm infants, length growth below expected growth during hospital stay predicts poor neurodevelopment at 2 years. Neonatology. 2018;114:135–41.

    Article  Google Scholar 

  14. Belfort MB, Gillman MW, Buka SL, Casey PH, McCormick MC. Preterm infant linear growth and adiposity gain: trade-offs for later weight status and intelligence quotient. J Pediatr. 2013;163:1564–9.

    Article  Google Scholar 

  15. Ramel SE, Demerath EW, Gray HL, Younge N, Boys C, Georgieff MK. The relationship of poor linear growth velocity with neonatal illness and two-year neurodevelopment in preterm infants. Neonatology. 2012;102:19–24.

    Article  Google Scholar 

  16. Meyers JM, Tan S, Bell EF, Duncan AF, Guillet R, Stoll BJ, et al. Neurodevelopmental outcomes among extremely premature infants with linear growth restriction. J Perinatol. 2019;39:193–202.

    Article  CAS  Google Scholar 

  17. Vliegenthart RJS, van Kaam AH, Aarnoudse-Moens CSH, van Wassenaer AG, Wes, Onland W. Duration of mechanical ventilation and neurodevelopment in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2019;0:F1–5.

    Google Scholar 

  18. Patra K, Greene MM, Patel AL, Meier P. Maternal education level predicts cognitive, language, and motor outcome in preterm infants in the second year of life. Am J Perinatol. 2016;33:738–44.

    Article  Google Scholar 

  19. Lowe JR, Nolen TL, Vohr B, Adams-Chapman I, Duncan AF, Watterberg K. Effect of primary language on developmental testing in children born extremely preterm. Acta Paediatr. 2013;102:896–900.

    Article  Google Scholar 

  20. Van Veen S, Remmmers S, Aarnoudse-Moens CSH, Oosterlaan J, van Kaam AH, van Wassenaer-Leemhuis AG. Multilingualism was associated with lower cognitive outcomes in children who were born very and extremely preterm. Acta Paediatr. 2019;108:479–85.

    Article  Google Scholar 

  21. Patra K, Hamilton M, Johnson TJ, Greene M, Dabrowski E, Meier PP, et al. NICU human milk dose and 20-month neurodevelopmental outcome in very low birth weight infants. Neonatology. 2017;112:330–6.

    Article  Google Scholar 

  22. Lechner BE, Vohr BR. Neurodevelopmental outcomes of preterm infants fed human milk: a systematic review. Clin Perinatol. 2017;44:69–83.

    Article  Google Scholar 

  23. Bills SE, Johnston JD, Shi D, Bradshaw J. Social-environmental moderators of neurodevelopmental outcomes in youth born preterm: a systematic review. Child Neuropsychol. 2020;21:1–20.

    Google Scholar 

Download references

Acknowledgements

We thank Dr Pierpaolo Brovedani for the collaboration in the follow-up visits of the preterm infants of Our Unit. We also acknowledge our mentor Dr. Sergio Demarini.

Author information

Authors and Affiliations

Authors

Contributions

JB had primary responsibility for protocol development, supervision of data collection and curation, and writing of the manuscript. FMR participated in the development of the analytical framework for the study and reviewed the manuscript. MB was responsible for Bayley testing at 2 years of age. FV was responsible for initial data collection and participated in the preliminary data analysis. LT participated in data collection, in the development of the analytical framework for the study and review of the manuscript. GP supervised the design of the study, performed the final data analyses and contributed to the writing of the manuscript.

Corresponding author

Correspondence to Jenny Bua.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bua, J., Risso, F.M., Bin, M. et al. Association between body composition at term equivalent age and Bayley scores at 2 years in preterm infants. J Perinatol 41, 1852–1858 (2021). https://doi.org/10.1038/s41372-021-01074-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41372-021-01074-x

This article is cited by

Search

Quick links