Related Experiment Video
Updated: Aug 31, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Body composition in preterm infants: a systematic review on measurement methods
Dana F J Yumani1, Dide de Jongh2,3, Johannes C F Ket4
1Department of Pediatrics, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands. d.yumani@amsterdamumc.nl.
Insights
Accurate body composition measurement in preterm infants remains challenging. While dual-energy x-ray absorptiometry (DXA), air displacement plethysmography (ADP), and isotope dilution are trusted, their results may not be comparable.
Area of Science:
- Neonatal research
- Pediatric body composition analysis
- Clinical measurement validation
Background:
- Accurate body composition assessment is crucial for preterm infants, yet no single method is universally preferred.
- Existing measurement techniques lack standardized agreement, complicating clinical practice and research.
Approach:
- A systematic review of 1884 studies was conducted, focusing on body composition measurement validity in preterm infants up to 6 months corrected age.
- Included studies compared various methods like bioelectrical impedance and ultrasound against reference standards such as dual-energy x-ray absorptiometry (DXA), air displacement plethysmography (ADP), and isotope dilution.
Key Points:
- Predictive equations using weight, length, circumferences, skinfolds, bioelectrical impedance, and ultrasound showed poor agreement with reference methods.
- Air displacement plethysmography (ADP) demonstrated good agreement with isotope dilution for fat mass density but not for fat mass percentage.
- Dual-energy x-ray absorptiometry (DXA), magnetic resonance imaging (MRI), and isotope dilution were not extensively compared against other reference methods in preterm populations.
Conclusions:
- Dual-energy x-ray absorptiometry (DXA), air displacement plethysmography (ADP), and isotope dilution are considered validated and trustworthy techniques for assessing body composition in preterm infants.
- Despite their validated status, significant variability exists between these methods, indicating potential discrepancies in results and the need for further standardization.
Background:
There are several methods to measure body composition in preterm infants. Yet, there is no agreement on which method should be preferred.
Methods:
PubMed, Embase.com, Wiley/Cochrane Library, and Google Scholar were searched for studies that reported on the predictive value or validity of body composition measurements in preterms, up to 6 months corrected age.
Results:
Nineteen out of 1884 identified studies were included. Predictive equations based on weight and length indices, body area circumferences, skinfold thickness, bioelectrical impedance, and ultrasound did not show agreement with body composition measured with air displacement plethysmography (ADP), dual-energy x-ray absorptiometry (DXA), magnetic resonance imaging (MRI), or isotope dilution. ADP agreed well with fat mass density measured by isotope dilution (bias -0.002 g/ml, limits of agreement ±0.012 g/ml, n = 14). Fat mass percentage measured with ADP did not agree well with fat mass percentage measured by isotope dilution (limits of agreement up to ±5.8%) and the bias between measurements was up to 2.2%. DXA, MRI, and isotope dilution were not compared to another reference method in preterms.
Conclusions:
DXA, ADP, and isotope dilution methods are considered trustworthy validated techniques. Nevertheless, this review showed that these methods may not yield comparable results.
Impact:
Based on validation studies that were conducted in a limited number of study subjects, weight and length indices, body area circumferences, skinfold thickness, bioelectrical impedance, and ultrasound seem to be a poor representation of body composition in preterm infants. DXA, ADP, and isotope dilution methods are considered trustworthy and validated techniques. Nevertheless, these methods may not yield comparable results.
Related Concept Videos
01:52Regression Toward the Mean
01:14Temperature Measurement Sites
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...