The Association of Fat Mass Deviation with Neonatal Morbidities in Preterm Infants
Maria Lithoxopoulou1, Dimitrios Rallis1, Anastasia Gkampeta1
1Second Department of Neonatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Insights
Neonatal body fat mass (FM) is linked to health outcomes. Lower FM percentage in newborns is associated with increased risks of hypoglycemia, hypothermia, and respiratory distress syndrome.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Body Composition Analysis
Background:
- Neonatal body composition, particularly fat mass (FM), may offer insights into disrupted fetal growth and health.
- Current anthropometric measurements may not fully capture neonatal health risks.
Purpose of the Study:
- To investigate the association between neonatal body composition parameters and common morbidities.
- Specifically, to determine if neonatal body fat mass is linked to hypoglycemia, hypothermia, and respiratory distress syndrome.
Main Methods:
- Prospective study of preterm neonates (≤37 weeks gestational age).
- Body composition measured using bioelectrical impedance analysis (BIA) within the first week of life.
- Analysis adjusted for gestational age, sex, and antenatal steroid administration.
Main Results:
- Neonates with intrauterine growth restriction (IUGR) had significantly lower FM percentage.
- Decreased FM percentage was associated with higher rates of hypothermia, hypoglycemia, and respiratory distress syndrome.
- Low FM percentage showed significant associations with these morbidities (ORs ranging from 8.06 to 13.90).
Conclusions:
- Lower neonatal fat mass percentage is a stronger predictor of common morbidities than standard anthropometric measurements.
- Neonates with low FM percentage, even with normal birth weight, may require closer monitoring for undernutrition-related issues.
- This highlights the importance of assessing body composition for early identification of at-risk newborns.
Abstract:
Background/Objectives: Evidence suggests that assessment of neonatal body fat mass (FM) may provide additional insight into the relationship between disrupted fetal growth and neonatal health outcomes. Our objective was to determine whether neonatal body composition parameters are associated with hypoglycemia, hypothermia, and respiratory distress syndrome. Methods: We conducted a prospective study of preterm neonates born at ≤37 weeks of gestational age. Body composition was measured in the first week of life with bioelectrical impedance analysis (BIA). Results: We studied 101 neonates of mean gestational age 32.2 ± 3.2 weeks and mean birth weight 1792 ± 706 g. Neonates with intrauterine growth restriction (IUGR) had a significantly lower FM percentage (6.8 ± 3.6 compared with 8.3 ± 3.6%, p = 0.038), and higher free-FM percentage (93.1 ± 3.6 compared with 91.6 ± 3.4%, p = 0.041), compared with non-IUGR neonates. Compared with neonates with normal FM, neonates with decreased FM presented higher rates of hypothermia (35% compared with 9%, p = 0.005), hypoglycemia (46% compared with 9%, p < 0.001), and respiratory distress syndrome (58% compared with 27%, p = 0.008). Decreased FM percentage was significantly associated with hypoglycemia (OR 8.06, 95%CI 2.49-26.08, p < 0.001), hypothermia (OR 8.11, 95%CI 2.24-29.32, p = 0.001), and respiratory distress syndrome (OR 13.90, 95%CI 4.07-27.42, p < 0.001) after adjusting for gestational age, sex, and antenatal steroid administration. Conclusions: Lower FM percentage showed stronger associations with common neonatal morbidities, compared with standard anthropometric measurements alone. When a low FM percentage is detected, even when birth weight is normal, neonates at risk of undernutrition-related morbidity may benefit from closer nutritional and metabolic monitoring.
