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Effect of intrauterine growth retardation on postnatal changes in body composition of preterm infants
1Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh.
Insights
Small for date (SFD) infants show early catch-up growth, gaining body solids during initial weight loss. This suggests intrauterine growth retardation impacts postnatal body composition changes differently than appropriate for gestational age (AGA) infants.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Human Physiology
Background:
- Intrauterine growth retardation (IUGR) affects fetal development, potentially influencing postnatal growth and body composition.
- Understanding body composition changes in preterm infants is crucial for optimizing nutritional support and long-term health outcomes.
Purpose of the Study:
- To investigate the effects of intrauterine growth retardation on postnatal body composition changes in preterm infants.
- To compare body composition dynamics between small for date (SFD) and appropriate for gestational age (AGA) preterm infants.
Main Methods:
- Studied nine preterm SFD and nine gestation-matched AGA infants.
- Measured total body water (TBW) and extracellular water (ECW) at birth, peak weight loss, and regain of birth weight.
- Calculated body solids from TBW and body weight.
Main Results:
- SFD infants exhibited significantly less postnatal weight loss than AGA infants.
- SFD infants showed a significant gain in body solids during the weight loss period, unlike AGA infants.
- While weight gain rates were similar, SFD infants had a higher proportion of solids in their weight gain compared to AGA infants.
- SFD infants started with less body solids per unit of weight but achieved similar body solids to AGA infants by regaining birth weight.
Conclusions:
- Preterm SFD infants initiate catch-up growth early, during the period of apparent weight loss.
- Intrauterine growth retardation influences postnatal body composition trajectories, with early solid gain observed in SFD infants.
- These findings highlight distinct postnatal adaptation strategies in SFD infants compared to AGA infants.
Abstract:
To find the effect of intrauterine growth retardation on postnatal changes in body composition, we studied nine preterm small for date (SFD) and 9 gestation matched appropriate for gestational age (AGA) infants (mean +/- SD birth weight - SFD : 1431 +/- 16I g, AGA : 1904 +/- 223 g, gestational age - SFD; 237 +/- 9 days, AGA : 236 +/- 7 days). Total body water (TBW) and extracellular water (ECW) were measured at birth, on the day of maximum weight loss and on regaining of birth weight. Body solids were calculated from the difference between TBW and body weight. SFD infants had significantly less postnatal weight loss (64 +/- 19 g) than AGA infants (135 +/- 49 g; P < 0.01) and showed a significant gain in body solids (19 +/- 12 g) during this period which was not seen in AGA infants (-4 +/- 14 g; P < 0.05). The subsequent weight gain occurred at similar rates in SFD (16 +/- 4 g/day) and AGA (18 +/- 6 g/day) infants, but a significantly higher ratio of the weight gain consisted of solids in SFD as compared to AGA infants (P < 0.05). Per unit of body weight, SFD infants had significantly less body solids (213 +/- 12 g/kg) than AGA infants (228 +/- 18 g/kg; P < 0.05) at birth, but by the time birth weight was regained the two groups of infants had similar probody solids (SFD: 248 +/- 7 g/kg, AGA : 255 +/- 12 g/kg). These results suggest that in SFD infants catch-up growth starts early, during the period of apparent weight loss.