Rapid BMI Increases and Persistent Obesity in Small-for-Gestational-Age Infants

Frontiers in Pediatrics

article

Dan Wu¹  Honghua Liu¹  Tingting Li¹  Lian Jiang¹  Xiangying Hu²  Tianshu Li³  Jing Xu⁴  Guoying Yao¹  Guowei Zhu⁵  Guangjun Yu¹  Jinjin Chen¹  Jianzheng Zhu⁶  Xiulian Wang¹  Huiqing Shi¹  Yanyan Huo¹  Meiyan Liu¹  Fanfan Sun¹  Hongyan Lan¹  Chong Guo⁷ 

[1] Shanghai Children's Hospital, Shanghai Jiao Tong University;Jing'an District Maternal and Child Healthcare Center;Huang'pu District Maternal and Child Healthcare Center;Yang'pu District Maternal and Child Healthcare Center;Xu'hui District Maternal and Child Healthcare Center;School of International and Public Affairs, Shanghai Jiao Tong University;Fujian Maternal and Child Health Hospital

关键词: SGA;    BMI changes;    obesity;    overweight;    pediatric;   

DOI  :  10.3389/fped.2021.625853

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Purpose: In order to compensate for the early intrauterine growth restriction, small-for-gestational age (SGA) infants have “catch-up growth” after birth. Increased caloric intake has been suggested for SGA infants conventionally. It is important to determine if the early growth rate of body mass index (BMI) is associated with risk of persistent obesity later in life. In this longitudinal cohort study, we assessed the BMI of a large cohort of children who were SGA at birth to determine their risk of persistent obesity at school age (6–7 years) due to excessive weight gain in the first 3 years of life. Methods: We collected the height and weight data of 23,871 SGA babies. A polynomial function was used to fit the BMI-for-age z-score (BAZ) values of 0–6 years old SGA children and interpolate their growth trajectory. In addition, we screened out 6,959 children from 23,871 children to further evaluate the dynamic changes of early childhood BMI. We divided the school-age children into groups as non-obese (BAZ 2), and determined the association between changes in BMI and school-age obesity. Results: From the perspective of BMI distribution, the interpolated growth trajectory indicated that SGA children reaching overweight status or developing obesity by 3 years of age, continued to have obesity until school age (R 2 , 0.65; R 2 , 0.21). The retrospective analysis showed that children who were overweight and had obesity during school age had a high BMI from early age. By analyzing the changes in early BMI, we found that the fastest growth of SGA children occurred in the early infancy before 6 months and they continued to grow rapidly for a period of time. Interestingly, former SGA children who maintained a near overweight (1 < BAZ < 2) status before the age of 2 maintained an appropriate growth rate and usually did not develop obesity. Conclusions: A rapid increase in BMI during early infancy in former SGA newborns leads to a persistent risk of obesity. The energy intake of SGA infants should appropriately meet the infants' growth needs and early BMI changes should be closely monitored for an optimal integrated management.

【 授权许可】

CC BY