Catch-up growth and metabolic outcomes in adolescents born preterm

Area of Science:

• Neonatalogy and Developmental Pediatrics
• Metabolic Health and Cardiovascular Risk
• Pediatric Endocrinology

Background:

• Accelerated infant weight gain is associated with adult cardiovascular risk in full-term births, but data for preterm infants are inconsistent.
• Understanding the long-term metabolic consequences of infant and childhood growth patterns in preterm populations is crucial.

Purpose of the Study:

• To investigate the association between infant and childhood weight gain and later metabolic syndrome markers in adolescents born preterm.
• To determine if early catch-up growth in preterm infants impacts adolescent metabolic health.

Main Methods:

• A longitudinal cohort study followed 153 preterm children (mean gestation 30.8 weeks).
• Auxology, body composition (DXA), blood pressure, insulin sensitivity, and lipid profiles were assessed in adolescence (median age 11.5 years).
• Infant and childhood weight gain patterns were analyzed in relation to adolescent metabolic outcomes.

Main Results:

• No significant associations were found between infant weight gain and adolescent metabolic outcomes.
• Rapid childhood weight gain (after 1 year) was strongly associated with adverse body composition (higher fat mass, larger waist circumference) and metabolic markers (higher fasting insulin, higher blood pressure, lower insulin sensitivity).
• Adolescent growth parameters were similar to population averages and did not differ based on early catch-up growth.

Conclusions:

• The timing of rapid weight gain is critical for health outcomes in preterm individuals; childhood gain, not early infancy gain, impacts adolescent metabolic status.
• Rapid weight gain in childhood after the first year should be discouraged in preterm adolescents.
• Further research is necessary before implementing strategies to discourage infant weight gain or catch-up in preterm infants due to the importance of neonatal brain growth.