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Updated: Nov 14, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
A systematic review indicates an association between birth weight and body fat in childhood
Dimitrios Rallis1, Foteini Balomenou1, Meropi Tzoufi2
1Neonatal Intensive Care Unit, University of Ioannina, School of Medicine, Ioannina, Greece.
Insights
Infants born small for gestational age show reduced birth fat mass but increased postnatal adiposity, with long-term outcomes remaining inconclusive. Large for gestational age infants have higher birth fat but lower long-term body fat, particularly with catch-down growth.
Area of Science:
- Pediatrics
- Human Growth and Development
- Body Composition Analysis
Background:
- Understanding body fat development in relation to fetal growth is crucial for long-term health.
- Small for gestational age (SGA) and large for gestational age (LGA) infants represent distinct growth trajectories with potential health implications.
- Existing evidence on the long-term body fat composition of SGA and LGA individuals requires synthesis.
Purpose of the Study:
- To systematically review and summarize the current evidence on body fat composition in individuals categorized as small or large for gestational age.
- To track body fat changes from birth up to 18 years of age in these cohorts.
- To identify trends and inconsistencies in body fat accumulation and distribution.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Inclusion of studies measuring body fat using validated methods: bioelectrical impedance analysis (BIA), air displacement plethysmography (ADP), dual-energy X-ray absorptiometry (DXA), or magnetic resonance imaging (MRI).
- Analysis of data from 31 studies covering the period from birth to 18 years of age.
Main Results:
- Small for gestational age (SGA) infants exhibit decreased fat mass at birth and increased adiposity postnatally.
- Long-term body fat evidence for SGA individuals is inconclusive; some studies link catch-up growth to increased fat accumulation, while others suggest neutral or negative associations.
- Large for gestational age (LGA) infants present with increased fat mass at birth but tend to have a lower body fat ratio long-term, especially with catch-down growth.
Conclusions:
- The long-term body fat trajectory for small for gestational age (SGA) individuals remains unclear, necessitating further research, particularly concerning catch-up growth.
- Large for gestational age (LGA) individuals demonstrate a pattern of reduced body fat in the long term, particularly when exhibiting catch-down growth.
- Clarifying the long-term metabolic and health consequences associated with these differing fetal growth patterns is essential.
Aim:
To summarise the existing evidence regarding the body fat of small or large for gestation subjects, evaluated from birth up to 18 years of age.
Methods:
The PRISMA guidelines were adopted for the current systematic review, including studies having evaluated body fat with bioelectrical impedance analysis, air displacement plethysmography, dual-energy X-ray absorptiometry or magnetic resonance imaging.
Results:
A total of 31 studies was included. The balance of evidence suggests that small for gestation infants have decreased fat mass at birth; postnatally they experience increased adiposity. In the long term, however, the evidence is inconclusive, since some studies suggest that foetal-restricted children with increased catch-up growth are at increased risk of fat accumulation, whereas other studies suggest a neutral or even negative association. Large for gestation infants have increased fat mass at birth, but in the long term, they have a lower body fat ratio, especially when they develop a catch-down growth.
Conclusion:
Some studies suggested that foetal-restricted children with increased catch-up growth are at increased risk of later adiposity, while other studies suggested a neutral or negative association. Given that the evidence is inconclusive, further studies are warranted. Large for gestation subjects have lower body fat when they develop catch-down growth.
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