Body Composition in Very Preterm Infants: Role of Neonatal Characteristics and Nutrition in Achieving Growth Similar to Term Infants Effects of size at birth, gestational age and early growth in preterm infants on glucose and insulin concentrations at 9–12 years Growth impairment in very low birthweight children at 12 years: correlation with perinatal and outcome variables. [Assessment of somatic development and body composition in the 7th year of life in children born as extremely low birth weight infants (≤1000g); a multi-centre cross-sectional study of a cohort born between 2002 and 2004 in the Malopolska voivodship]. Body composition and its components in preterm and term newborns: A cross‐sectional, multimodal investigation
Background : The identification of factors involved in the postnatal growth of preterm infants will help achieve growth similar to that of term infants . Objectives : As per protocol : to compare body composition in very preterm infants at term-corrected age ( TCA ) with that in term infants , and to explore relationships between neonatal characteristics and body composition in preterm infants . Methods : Anthropometry , nutritional characteristics , and neonatal outcomes were prospect ively collected in 26 preterm ( < 29 weeks ) and 33 term ( 37 - 40 weeks ) infants .  Body composition using  dual-energy X-ray absorptiometry ( DXA ) was measured at TCA in preterm infants and between days 7 and 10 in term infants . Results : Parenteral nutrition in preterm infants provided a mean of 2.9 ± 0.2 and 2.1 ± 0.5 g/kg/day of  intravenous amino acids and lipids  , respectively , during the first week of life . The mean weight gain velocity from birth to DXA assessment was 12.1 ± 1.4 g/kg/day . Compared with term infants , preterm infants at TCA were shorter and lighter , with a smaller head circumference , a lower weight estimated by DXA ( 2,960 ± 552 vs. 3,843 ± 377 g ) , and increased skinfold thicknesses . Fat mass percent ( 13.9 ± 5.4 % ) and lean mass percent ( 84.7 ± 5.6 % ) in preterm infants were similar to those in term infants ( 14.7 ± 3.5 and 83.5 ± 3.6 % , respectively ) . Neonatal weight gain velocity in preterm infants was positively associated with lean mass ( grams ) . Conclusion : Subcutaneous fat is increased in preterm infants . Higher protein intake in preterm infants might increase weight gain velocity and achieve a lean mass comparable to that of term infants Aims /hypothesis . To test the hypothesis that small size for gestation and poor postnatal growth in preterm infants is associated with higher fasting and post-load plasma glucose and insulin concentrations at 9–12 years of age.¶ Methods . Prospect i ve follow-up at 9–12 years of 385 preterm children with birth weight less than 1850 g , who had anthropometry recorded at birth , 18 months and 7 years .  Fasting plasma glucose , insulin , proinsulin and 32,33 split proinsulin concentrations and glucose and insulin concentrations 30 min after a st and ard glucose load were measured.¶ Results . Post-load glucose concentrations were negatively related to birth weight , independently of gestation or subsequent growth . Fasting split proinsulin and 30-min insulin concentrations were highest in children who showed the greatest increase in weight centile between birth and current follow-up , regardless of gestation . When weight during childhood was included , birthweight centile was , however , no longer statistically significant : concentrations of fasting , split , proinsulin and 30-min insulin were highest in those children who had shown the greatest increase in weight centile between 18 months of age and current follow-up , with no evidence of a greater effect in those who were smallest at 18 months.¶ Conclusion /interpretation . Our findings suggest that fetal growth influences plasma glucose 30 min after a glucose load in preterm children at 9–12 years . In contrast , childhood weight gain is the most important factor influencing insulin concentrations and this effect is the same regardless of early size . [ Diabetologia ( 2000 ) 43 : 714–717 AIM : To compare the growth of very low birthweight ( VLBW ) children in early adolescence with that of their normal birthweight peers ; to examine the role of factors contributing to growth-parental height , perinatal variables , bone maturity and sexual maturation ; to examine the correlation between head growth and cognitive and educational outcome . METHODS : St and ing and sitting heights , weight , occipito-frontal circumference ( OFC )  ,  skinfold thicknesses  and  pubertal staging  were assessed in 137 VLBW children and 160 controls at 11 - 13.5 years of age . Ninety six ( 70 % ) of the VLBW children had their bone age assessed using the TW2 method . Reported parental heights were obtained by question naire . All children had st and ardised tests of cognitive and educational ability . Perinatal data had been collected prospect ively as part of a longitudinal study . RESULTS : VLBW children had lower heights , weight , and OFC . Skinfold thicknesses were no different . The children 's short stature was not accounted for by difference in parental height , degree of pubertal development , or by retarded bone age . Indeed , the TW2 RUS score was significantly advanced in the VLBW children . Using the bone ages to predict final adult height , 17 % have a predicted height below the third centile and 33 % below the tenth . Weight was appropriate for height , but there was a residual deficiency in OFC measurements after taking height into account . In the VLBW group smaller head size was associated with lower IQ and mathematics and reading scores . CONCLUSIONS : Growth problems persist in VLBW children and final heights may be even more abnormal than present heights suggest . VLBW children have smaller OFCs than expected from their short stature alone and this may be associated with poorer educational and cognitive outcomes UNLABELLED Children born with extremely low birth weight often present delayed growth in the first years of their lives : they remain shorter and weigh less than their peers . Current reports published worldwide state that later in life these children are at an increased risk of cardiac and vascular diseases , diabetes and obesity . Abnormal distribution and the excess of fat tissue predispose them to develop the metabolic syndrome . THE AIM of the study was to evaluate the somatic development of seven-year-old children born with birth-weight ≤1000 g ( ELBW ) in the Malopolska voivodship and to estimate the content and distribution of fat tissue . Moreover , the risk factors of disturbed somatic development were evaluated . MATERIAL S AND METHODS Two hundred and four live newborns with birth weight ≤1000 g were born in the Malopolska voivodship between 1.09.2002 and 31.08.2004 . One hundred and fifteen of these children ( 56 % ) died in early infancy . The study included 81 children in the 7th year of life out of the 89 surviving ones . Their mean gestational age at birth was 27.3 weeks . ( SD : 2.1 weeks ) and their mean birth-weight was 840 g ( SD : 130 g ) . All the children underwent  anthropometric measurements  and the thickness of the skin fold over the triceps  was measured . Body mass index ( BMI ) was calculated and the body composition was assessed by multifrequency bioimpedance . The control group consisted of 39 children born at term chosen r and omly from the general population and matched with regard to age and sex . RESULTS The ELBW children in the 7th year of life were shorter ( z-score : -1.06±1.4 p<0.001 ) , had lower body mass ( z-score : -0.57±0.9 ; p=0.01 ) , smaller head circumference ( z-score : -1.2±1.3 ; p<0.001 ) , lower BMI ( z-score : -0.99±1.6 ; p<0.001 ) as compared to their peers . Fat tissue mass was lower in the ELBW group than in the control group ( 11 % vs 16 % ; p<0.01 ) . The most retarded somatic development was observed in the group of children suffering from cerebral palsy . CONCLUSIONS 1 . Children born with ELBW , at 7 years of life , present significantly retarded somatic development as compared with their full-term peers . 2 . The most important risk factor of somatic development disturbances is cerebral palsy . 3 . Children born with low birth weight and ELBW , need long term follow up A prospect i ve , cross‐sectional , observational study in preterm and term infants was performed to compare multimodal measurements of body composition , namely , limb ultrasound , bone quantitative ultrasound , and dual X‐ray absorptiometry ( DXA ) .  One hundred and two preterm and term infants appropriate for gestational age were enrolled from the newborn nursery and neonatal intensive care unit . Infants were included when they were medically stable , in an open crib , on full enteral feeds and within 1 week of anticipated discharge . Correlations among the various measurements of body composition were performed using st and ard techniques . A comparison between preterm infant ( born at 28–32 weeks ) reaching term to term‐born infants was performed . Limb ultrasound estimates of cross‐sectional areas of lean and fat tissue in a region of tissue ( i.e. , the leg ) were remarkably correlated with regional and whole‐body estimates of fat‐free mass and fat obtained from DXA suggesting the potential usefulness of muscle ultrasound as an investigative tool for study ing aspects of body composition in this fragile population . There was a weak but significant correlation between quantitative ultrasound  measurements of bone strength and DXA‐derived bone mineral density ( BMD ) . Preterm infants reaching term had significantly lower body weight , length , head circumference , muscle and fat cross‐sectional area , bone speed of sound , whole‐body and regional lean body mass , fat mass , and BMD compared to term‐born infants . Current postnatal care and nutritional support in preterm infants is still unable to match the in‐utero environment for optimal growth and bone development . The use of relatively simple bedside , noninvasive body composition measurements may assist in underst and ing how changes in different components of body composition early in life affect later growth and development . Am . J. Hum . Biol . 2010 . © 2009 Wiley‐Liss ,
Preterm infants are obviously born lighter and shorter , with smaller head circumferences than normal birth weight term born neonates .
They also have a different body composition .
Compromised growth is associated with adverse health outcomes .
Both growth retardation and accelerated growth are suggested to cause metabolic , cardiovascular , and renal complications .
Review s regarding growth and body composition in preterm infants often do not differentiate between birth weight and gestational age .
The purpose of this systematic review is to assemble growth data , specific in extremely low birth weight children .