Postnatal conditional growth and size and body composition at 24 months in moderate-and-late preterm children
Subhasish Das1, Frank H Bloomfield1, Tanith Alexander1,2
1Liggins Institute, University of Auckland, Auckland, New Zealand.
Insights
Postnatal growth in size and body composition after hospital discharge significantly impacts the development of moderate- and late-preterm infants by 24 months corrected age. Early growth trajectories are key indicators for later outcomes.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Moderate- and late-preterm infants (32-35 weeks gestation) face unique growth challenges.
- Understanding postnatal growth's impact on long-term outcomes is crucial for this population.
Purpose of the Study:
- To assess the relationship between postnatal conditional growth and size/body composition at 24 months corrected age.
- To determine if early growth patterns predict later physical development in MLPT infants.
Main Methods:
- Longitudinal study of 343 MLPT infants (32-35 weeks gestation) from New Zealand.
- Conditional growth curve models analyzed weight, length, head circumference, fat mass (FM), and fat-free mass (FFM) z-scores.
- Data collected at discharge, 4 months, and 24 months corrected age.
Main Results:
- Post-discharge growth, particularly FM z-score at 4 months and FFM z-score at 24 months, showed stronger associations with 24-month outcomes than earlier measures.
- Growth patterns did not differ between moderate (32-33 weeks) and late (34-35 weeks) preterm infants.
- Growth differed significantly by sex, small-for-gestational-age status, and ethnicity.
Conclusions:
- Postnatal growth trajectory after hospital discharge is a critical determinant of size and body composition at 24 months corrected age in MLPT infants.
- The timing of growth, especially in the first year, plays a significant role in long-term physical development for this vulnerable group.
Background:
To assess the relationship between postnatal conditional growth and size and body composition at 24 months' corrected age (CA) in children born moderate-and-late preterm (MLPT).
Methods:
Children born MLPT (32+0-35+6 weeks' gestation) were recruited to the Different Approaches to Moderate & late preterm Nutrition: Determinants of feed intolerance, body composition, and development randomized trial from neonatal units in New Zealand. The relationships between growth in weight, length, and head circumference z-scores and body composition (fat mass (FM) and fat-free mass (FFM) z-scores) at discharge, 4 and 24 m and anthropometry and body composition at 24 m was assessed using conditional growth curve models.
Results:
In 343 children with longitudinal data (mean (standard deviation) gestation 33.4 (1.0) weeks; birthweight 2120 (424) g), growth in size and body composition after hospital discharge, specifically FM z-score at 4 m and FFM z-score at 24 m, had stronger associations with size and body composition at 24 m than measures at or before discharge. Growth patterns were not different between moderate- and late-preterm infants (32-33 and 34-35 weeks) but differed between sexes, small-for-gestational-age ( < 10th percentile) and ethnicities.
Conclusion:
In children born MLPT, growth in size and body composition after discharge is important for size at 24 months.
Impact:
The influence of timing of growth on later size and body composition in children born moderate-and-late preterm is unknown. Growth in fat mass z-score at 4 months and fat-free mass z-score at 24 months had stronger associations with size and body composition at 24 months than measures at or before discharge. Growth in size and body composition after discharge is important for size at 24 months in children born moderate-and-late preterm.
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