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

Mandy B Belfort1, Matthew W Gillman, Stephen L Buka

  • 1Division of Newborn Medicine, Boston Children's Hospital, Boston, MA.

The Journal of Pediatrics
|August 6, 2013
PubMed

Insights

Faster infant growth in preterm babies is linked to better cognitive outcomes but increased risk of obesity. Rapid weight gain in infancy also correlates with higher obesity risk later in childhood and young adulthood.

Area of Science:

  • Pediatric Growth and Development
  • Childhood Obesity Research
  • Neurodevelopmental Outcomes

Background:

  • Preterm infants are at increased risk for both cognitive deficits and obesity.
  • Understanding the relationship between early growth patterns and later outcomes is crucial for intervention.
  • Infant growth trajectories significantly influence long-term health and developmental trajectories.

Purpose of the Study:

  • To investigate the trade-offs between cognitive development and overweight/obesity in preterm infants.
  • To analyze the impact of infant weight gain and linear growth on school-age and young adult outcomes.
  • To assess the relationship between early growth patterns and later cognitive function and BMI.

Main Methods:

  • A longitudinal study of 945 preterm, low birth weight infants from birth to 18 years.
  • Logistic regression analysis adjusted for maternal and child factors.
  • Examined odds of overweight/obesity and low IQ based on z-score changes in infant length and BMI at specific intervals.

Main Results:

  • Rapid linear growth from term to 4 months was associated with lower odds of low IQ but higher odds of overweight/obesity at age 8.
  • Accelerated body mass index (BMI) gain in infancy was linked to increased odds of overweight/obesity.
  • BMI gain from 4-12 months showed association with lower odds of low IQ at age 8, with similar trends at age 18.

Conclusions:

  • Faster early linear growth in preterm infants offers cognitive benefits but elevates risks for later overweight/obesity.
  • Infant BMI gain throughout the first 18 months is a significant predictor of later overweight/obesity.
  • The findings highlight complex trade-offs between early growth, cognition, and metabolic health in preterm populations.
Abstract

Keywords:
BMIBody mass indexIHDPInfant Health and Development ProgramNICUNeonatal intensive care unitSGASmall for gestational age

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