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Updated: Sep 3, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Newborn body composition and child cardiovascular risk markers: a prospective multi-ethnic Asian cohort study
Yi Ying Ong1, Mya-Thway Tint2,3, Izzuddin M Aris4
1Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Insights
Low birth adiposity, not fat-free mass, is linked to higher childhood blood pressure and hypertension risk. This suggests newborn body composition may predict future cardiovascular health outcomes.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Developmental Origins of Health and Disease
Background:
- Epidemiological studies suggest a link between low birthweight and increased cardiovascular risk.
- The distinct roles of fat and fat-free mass in birthweight concerning cardiovascular risk markers in childhood require further investigation.
Purpose of the Study:
- To examine the differential associations of newborn fat mass and fat-free mass with childhood cardiovascular risk markers.
- To determine if components of birthweight predict blood pressure trajectories and hypertension risk in children.
Main Methods:
- Analysis of data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, including 290 naturally conceived singletons.
- Measurement of newborn body composition (fat mass, fat-free mass, body fat percentage) within 24 hours of delivery using air displacement plethysmography.
- Assessment of childhood cardiovascular risk markers at age 6, including carotid intima-media thickness, pulse wave velocity, blood pressure, and prehypertension/hypertension, while controlling for various maternal and child factors.
Main Results:
- Lower newborn fat mass and body fat percentage were inversely associated with childhood blood pressure (systolic and diastolic).
- Children in the lowest tertile of newborn fat mass or body fat percentage exhibited higher blood pressure trajectories and increased risk of prehypertension/hypertension.
- No significant associations were found between fat-free mass and childhood blood pressure trajectories or hypertension risk.
Conclusions:
- Low adiposity at birth is associated with elevated blood pressure in childhood.
- Newborn adiposity may serve as a potential marker for poor fetal growth or suboptimal intrauterine conditions, indicating future hypertension risk.
Background:
Early epidemiological studies have associated low birthweight with increased cardiovascular risk. We aimed to examine whether the fat and fat-free components of birthweight have differing relationships with childhood cardiovascular risk markers.
Methods:
In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, air displacement plethysmography was conducted within 24 h after delivery in 290 naturally conceived singletons. We investigated associations of newborn cohort-specific standardized z-score of fat mass, fat-free mass, body fat percentage and birthweight on child (at 6 years of age) carotid intima-media thickness, pulse wave velocity, blood pressure, prehypertension/hypertension (>110/70 mmHg) and standardized systolic and diastolic blood pressure (SBP and DBP) trajectories (at 3-6 years of age), taking account of maternal education, height, tobacco exposure, parity, ethnicity, child's sex, gestational age, age at follow-up, and other maternal factors.
Results:
Clear inverse associations were seen for blood pressure with z-score of fat mass [SBP, β (95% CI): -1.31 mmHg (-2.57, -0.06); DBP: -0.79 mmHg (-1.74, 0.15)] and body fat percentage [SBP: -1.46 mmHg (-2.73, -0.19); DBP: -0.80 mmHg (-1.75, 0.16)], but not with fat-free mass [SBP: 0.27 mmHg (-1.29, 1.83)]; DBP: -0.14 mmHg (-1.30, 1.03)]. Being in the lowest tertile of fat mass or body fat percentage was associated with higher blood pressure trajectories and prehypertension/hypertension risk [OR (95% CI), fat mass: 4.23 (1.41, 12.68); body fat percentage: 3.22 (1.09, 9.53)] without concomitantly higher overweight/obesity risk.
Conclusions:
At birth, low adiposity was associated with increased childhood blood pressure. Low newborn adiposity might serve as a marker of poor fetal growth or suboptimal intrauterine conditions associated with hypertension risk later in life.
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