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Updated: Sep 14, 2025

Assessment of Child Anthropometry in a Large Epidemiologic Study
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Suboptimal BMI in 5-year-old children born very preterm: a European multicountry cohort

Soodabeh Behboodi1, Barbara Heude2, Pauline Scherdel2

  • 1Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical, Perinatal and Pediatric Lifecourse Epidemiology, OPPaLE, Paris, France soodabeh.behboodi@inserm.fr.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|July 23, 2025
PubMed

Insights

Many children born very preterm (VPT) have suboptimal body mass index (BMI) at age five, with underweight being most common. Risk factors differ for underweight and overweight/obesity (OWOB) in these high-risk children.

Area of Science:

  • Pediatric Endocrinology
  • Neonatal Research
  • Public Health Nutrition

Background:

  • Very preterm (VPT) birth (<32 weeks gestation) is associated with altered growth and metabolic outcomes.
  • Understanding the prevalence and risk factors for abnormal body mass index (BMI) in VPT children is crucial for long-term health.
  • Suboptimal BMI, including underweight and overweight/obesity (OWOB), may indicate future health complications.

Purpose of the Study:

  • To determine the prevalence of underweight and OWOB in 5-year-old children born VPT.
  • To identify sociodemographic, perinatal, and neonatal risk factors associated with underweight and OWOB in this population.

Main Methods:

  • Multinational, area-based cohort study including children born VPT across 19 European regions.
  • Children born before 32 weeks gestation between 2011-2012 were followed up at 5 years of age.
  • BMI was classified using International Obesity Task Force references; multinomial logistic regression analyzed risk factors, with advanced statistical methods for missing data and attrition.

Main Results:

  • 27.6% of VPT children were underweight, and 10.8% were OWOB at 5 years.
  • Risk factors for underweight included younger maternal age, fetal growth restriction, postnatal steroid use, and bronchopulmonary dysplasia.
  • Risk factors for OWOB included low maternal education, unemployment, non-European maternal origin, male sex, and multiple birth.

Conclusions:

  • A significant proportion (38%) of VPT children exhibit suboptimal BMI at age 5, primarily underweight.
  • Underweight and OWOB in VPT children share some risk factors (e.g., fetal growth restriction) but also have distinct associated factors.
  • These findings highlight the need to investigate underlying mechanisms and long-term growth and metabolic trajectories in VPT children with suboptimal BMI.
Abstract

Keywords:
Child DevelopmentEpidemiologyGrowthNeonatologyPaediatrics

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