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Updated: Jul 19, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Small for gestational age preterm infants and later adiposity and height: A systematic review and meta-analysis
Seham Elmrayed1,2,3,4,5, Jahaira Pinto6, Suzanne C Tough1,2,3
1Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Insights
Infants born small for gestational age (SGA) preterm have lower body mass, waist circumference, lean mass, and height later in life. Adiposity did not differ between preterm SGA and non-SGA infants.
Area of Science:
- Pediatric Health
- Neonatalogy
- Growth and Development
Background:
- Overweight and obesity are significant global health issues.
- Potential origins of excess adiposity may start in fetal life.
- It remains unknown if this applies to infants born preterm.
Purpose of the Study:
- To assess the association between small for gestational age (SGA) birth and later adiposity and height in preterm infants.
- Investigate long-term growth outcomes for preterm infants based on gestational age classification.
- Examine anthropometric differences between preterm SGA and non-SGA populations.
Main Methods:
- A systematic review and meta-analysis of studies published until October 2022.
- Included studies reported anthropometric outcomes (adiposity and height) for preterm infants classified as SGA versus non-SGA.
- Data extraction and risk of bias assessments were performed in duplicate.
Main Results:
- Meta-analysis of 39 studies (n > 30,000) revealed preterm SGA infants had lower BMI, waist circumference, lean mass, and height compared to non-SGA preterm infants.
- Specific findings include -0.66 kg/m² lower BMI and -3.85 cm lower height.
- No significant differences were found in various adiposity measures, though statistical power was limited for some.
Conclusions:
- Preterm infants born SGA exhibit reduced BMI, waist circumference, lean body mass, and height in later life compared to their non-SGA preterm peers.
- No significant differences in adiposity were observed between the SGA preterm and non-SGA preterm groups.
- These findings highlight distinct long-term growth trajectories for preterm infants based on SGA status.
Background:
Overweight and obesity and their consequent morbidities are important worldwide health problems. Some research suggests excess adiposity origins may begin in fetal life, but unknown is whether this applies to infants born preterm.
Objective:
The objective of the study was to assess the association between small for gestational age (SGA) birth and later adiposity and height among those born preterm.
Data Sources:
MEDLINE, EMBASE and CINAHL until October 2022.
Study Selection And Data Extraction:
Studies were included if they reported anthropometric (adiposity measures and height) outcomes for participants born preterm with SGA versus non-SGA. Screening, data extraction and risks of bias assessments were conducted in duplicate by two reviewers.
Synthesis:
We meta-analysed across studies using random-effects models and explored potential heterogeneity sources.
Results:
Thirty-nine studies met the inclusion criteria. In later life, preterm SGA infants had a lower body mass index (-0.66 kg/m2 , 95% CI -0.79, -0.53; 32 studies, I2 = 16.7, n = 30,346), waist circumference (-1.20 cm, 95% CI -2.17, -0.23; 13 studies, I2 = 19.4, n = 2061), lean mass (-2.62 kg, 95% CI -3.45, 1.80; 7 studies, I2 = 0, n = 205) and height (-3.85 cm, 95% CI -4.73, -2.96; 26 studies, I2 = 52.6, n = 4174) compared with those preterm infants born non-SGA. There were no differences between preterm SGA and preterm non-SGA groups in waist/hip ratio, body fat, body fat per cent, truncal fat per cent, fat mass index or lean mass index, although power was limited for some analyses. Studies were rated at high risk of bias due to potential residual confounding and low risk of bias in other domains.
Conclusions:
Compared to their preterm non-SGA peers, preterm infants born SGA have lower BMI, waist circumference, lean body mass and height in later life. No differences in adiposity were observed between SGA preterm infants and non-SGA preterm infants.
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