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Factors affecting body composition in preterm infants: Assessment techniques and nutritional interventions
K Strydom1, E Van Niekerk1, M A Dhansay2
1Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa.
Insights
Preterm infants often experience abnormal body composition, with increased fat mass and reduced fat-free mass, potentially leading to long-term health issues. The Dauncey anthropometric model offers a simple, accurate method for assessing their growth quality.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
- Body composition analysis
Background:
- Preterm infants struggle to achieve extra-uterine growth rates comparable to term infants.
- Abnormal body composition, including increased intra-abdominal adiposity, is observed in preterm infants during catch-up growth.
- This altered composition impacts weight gain quality, leading to shorter stature, lower weight, higher fat mass, and reduced fat-free mass.
Purpose of the Study:
- To review methods for assessing body composition in preterm infants.
- To identify an accurate, non-invasive, and cost-effective method for body composition assessment.
- To emphasize the importance of accurate assessment for optimizing nutritional interventions and long-term health outcomes.
Main Methods:
- Literature review of methods for determining body composition in preterm infants.
- Evaluation of the Dauncey anthropometric model for its suitability and accuracy.
- Consideration of simplicity, speed, non-invasiveness, and cost-effectiveness.
Main Results:
- Preterm infants exhibit higher fat percentage due to increased fat mass and decreased fat-free mass compared to term infants.
- These compositional differences can predispose preterm infants to metabolic syndrome and cardiovascular problems later in life.
- The Dauncey anthropometric model is identified as the most suitable method for accurate body composition assessment in preterm infants.
Conclusions:
- Accurate assessment of preterm infant growth quality and body composition is crucial.
- The Dauncey model provides a reliable method, particularly in resource-limited settings.
- Timely and appropriate nutritional interventions, guided by accurate assessments, are essential for improving short- and long-term health outcomes.
Abstract:
Limited research has been conducted that elucidates the growth and body composition of preterm infants. It is known that these infants do not necessarily achieve extra-utero growth rates and body composition similar to those of their term counterparts. Preterm infants, who have difficulty in achieving these growth rates, could suffer from growth failure. These infants display an increased intra-abdominal adiposity and abnormal body composition when they achieve catch-up growth. These factors affect the quality of weight gain, as these infants are not only shorter and lighter than term infants, they also have more fat mass (FM) and less fat-free mass (FFM), resulting in a higher total fat percentage. This could cause metabolic syndrome and cardiovascular problems to develop later in a preterm infant's life. The methods used to determine body composition in preterm infants should be simple, quick, non-invasive and inexpensive. Available literature was reviewed and the Dauncey anthropometric model, which includes skinfold thickness at two primary sites and nine body dimensions, is considered in this review the best method to accurately determine body composition in preterm infants, especially in resource-poor countries. It is imperative to accurately assess the quality of growth and body composition of this fragile population in order to determine whether currently prescribed nutritional interventions are beneficial to the overall nutritional status and quality of life-in the short- and long-term-of the preterm infant, and to enable timely implementation of appropriate interventions, if required.
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