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Association between preterm infant body composition in the first 3 months of life and preschool age: a cohort study

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Abstract

Compared with full-term infants, preterm infants have fat-free mass deficit in the first months of life, which increases the risk of metabolic diseases in the future. In this cohort of children born under 32-week gestational age or less than 1500 g, we aimed to evaluate the associations of body composition at term equivalent age and in the first 3 months of life with fat-free mass and fat mass percentage at 4 to 7 years of life. Body composition assessments by air displacement plethysmography and anthropometry were performed at term, at 3 months of corrected age, and at 4 to 7 years of age. Multiple linear regression analysis was used to observe the associations between body composition at these ages. At term, fat mass percentage showed a negative association and fat-free mass a positive association with fat-free mass at 4 to 7 years. The fat-free mass at 3 months and the gain in fat-free mass between term and 3 months showed positive associations with fat-free mass at 4 to 7 years.

   Conclusion: Body composition at preschool age is associated with fat-free mass in the first 3 months of life, a sensitive period for the risk of metabolic diseases.

What is Known:

• Preterm infants have a deficit in fat-free mass and high adiposity at term equivalent age compared to full-term infants.

• Fat-free mass reflects metabolic capacity throughout life and therefore is considered a protective factor against the risk of metabolic syndrome.

What is New:

•Fat-free mass gain in the first 3 months of corrected age is associated with fat-free mass at preschool and school ages.

•The first 3 months of life is a sensitive period to the risk of metabolic diseases.

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Data Availability

No datasets were generated or analysed during the current study.

Abbreviations

APGAR:

Viability score at birth

BMI:

Body mass index

FFM:

Fat-free mass

FM:

Fat mass

FFMI:

Fat-free mass index

FMI:

Fat mass index

H:

Height

IFF/Fiocruz:

Instituto Nacional em Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira

HIV:

Human immunodeficiency virus

NICU:

Neonatal intensive care unit

SD:

Standard deviation

TORCH:

Toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis

WHO:

World Health Organization

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Acknowledgements

The authors wish to thank Natasha Cohen from Holtz Children’s Hospital, Neonatology Department, University of Miami, for critical appraisal of the study.

Funding

This study was supported by FAPERJ (Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro).

Author information

Authors and Affiliations

  1. Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Oswaldo Cruz Foundation, FIOCRUZ, Avenida Rui Barbosa 716, Flamengo, Rio de Janeiro/RJ, CEP, Neonatology, 22250020, Brazil

    Sylvia Reis Gonçalves Nehab, Letícia Duarte Villela & Saint Clair S. Gomes Junior

  2. Applied Clinical Research, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro/RJ, Brazil

    Andrea Dunshee Abranches, Fernanda Valente Mendes Soares & Maria Elisabeth Lopes Moreira

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  1. Sylvia Reis Gonçalves Nehab
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Contributions

S.R.G.N., M.E.L.M., and L.D.V. had primary responsibility for protocol development, patient screening, enrollment, outcome assessment, and writing the manuscript. S.R.G.N., M.E.L.M., L.D.V., and S.C.G.J. participated in the preliminary data analysis. S.R.G.N., M.E.L.M., L.D.V., F.V.M.S., A.D.A., and S.C.G.J. participated in the development of the protocol and analytical framework for the study and contributed to the writing of the manuscript. M.E.L.M., L.D.V., and S.C.G.J. supervised the design and execution of the study, performed the final data analyses, and contributed to the writing of the manuscript. All the authors have read and approved the final manuscript.

Corresponding author

Correspondence to Sylvia Reis Gonçalves Nehab.

Ethics declarations

Ethics approval

This study was conducted in accordance with the Good Clinical Practice guidelines and the ethical standards defined in the 1964 Declaration of Helsinki and was approved by the Institution’s Ethics Committee of IFF/Fiocruz under Opinion No. CAAE 00754612.9.0000.5269.

Consent to participate

Informed consent forms were signed by all participants’ legal guardians.

Competing interest

The authors declare no competing interests.

Additional information

Communicated by Daniele De Luca

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Nehab, S.R.G., Villela, L.D., Abranches, A.D. et al. Association between preterm infant body composition in the first 3 months of life and preschool age: a cohort study. Eur J Pediatr (2024). https://doi.org/10.1007/s00431-024-05603-6

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