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Observational Study
. 2013 Dec;163(6):1564-1569.e2.
doi: 10.1016/j.jpeds.2013.06.032. Epub 2013 Jul 30.

Preterm infant linear growth and adiposity gain: trade-offs for later weight status and intelligence quotient

Mandy B Belfort  1 , Matthew W Gillman, Stephen L Buka, Patrick H Casey, Marie C McCormick
Affiliations
Observational Study

Preterm infant linear growth and adiposity gain: trade-offs for later weight status and intelligence quotient

Mandy B Belfort et al. J Pediatr. 2013 Dec.

Abstract

Objective: To examine trade-offs between cognitive outcome and overweight/obesity in preterm-born infants at school age and young adulthood in relation to weight gain and linear growth during infancy.

Study design: We studied 945 participants in the Infant Health and Development Program, an 8-center study of preterm (≤37 weeks gestational age), low birth weight (≤2500 g) infants from birth to age 18 years. Adjusting for maternal and child factors in logistic regression, we estimated the odds of overweight/obesity (body mass index [BMI] ≥85th percentile at age 8 or ≥25 kg/m(2) at age 18) and in separate models, low IQ (<85) per z-score changes in infant length and BMI from term to 4 months, from 4 to 12 months, and from 12 to 18 months.

Results: More rapid linear growth from term to 4 months was associated with lower odds of IQ <85 at age 8 years (OR, 0.82; 95% CI, 0.70-0.96), but higher odds of overweight/obesity (OR, 1.27; 95% CI, 1.05-1.53). More rapid BMI gain in all 3 infant time intervals was also associated with higher odds of overweight/obesity, and BMI gain from 4-12 months was associated with lower odds of IQ <85 at age 8. Results at age 18 were similar.

Conclusion: In these preterm, low birth weight infants born in the 1980s, faster linear growth soon after term was associated with better cognition, but also with a greater risk of overweight/obesity at age 8 years and 18 years. BMI gain over the entire 18 months after term was associated with later risk of overweight/obesity, with less evidence of a benefit for IQ.

Keywords: BMI; Body mass index; IHDP; Infant Health and Development Program; NICU; Neonatal intensive care unit; SGA; Small for gestational age.

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Figures

Figure 1
Figure 1
Participant flow
Figure 2
Figure 2
Participant body mass index (BMI) and length z-scores at term, 4, 12, and 18 months corrected age. A z-score of 0 represents the mean for the reference population.(45)
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