Associations of Fetal and Infant Weight Change With General, Visceral, and Organ Adiposity at School Age

Abstract

Importance Both fetal and infant growth influence obesity later in life. The association of longitudinal fetal and infant growth patterns with organ fat is unknown. Objective To examine the associations of fetal and infant weight change with general, visceral, and organ adiposity at school age. Design, Setting, and Participants This cohort study was embedded in the Generation R Study, a population-based prospective cohort study in Rotterdam, the Netherlands. Pregnant women with a delivery date between April 2002 and January 2006 were eligible to participate. Follow-up measurements were performed for 3205 children. Data analysis of this population was performed from July 26, 2018, to February 7, 2019. Exposures Fetal weight was estimated in the second and third trimester of pregnancy. Infant weight was measured at 6, 12, and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change in standard deviation scores greater than 0.67 between 2 ages. Main Outcomes and Measures Visceral fat index, pericardial fat index, and liver fat fraction were measured by magnetic resonance imaging. Results The sample consisted of 3205 children (1632 girls [50.9%]; mean [SD] age, 9.8 [0.3] years). Children born small for gestational age had the lowest median body mass index compared with children born appropriate for gestational age and large for gestational age (16.4 [90% range, 14.1-23.6] vs 16.9 [90% range, 14.4-22.8] vs 17.4 [90% range, 14.9-22.7]). Compared with children with normal fetal and infant growth (533 of 2370 [22.5%]), those with fetal weight deceleration followed by infant weight acceleration (263 of 2370 [11.1%]) had the highest visceral fat index (standard deviation scores, 0.18; 95% CI, 0.03-0.33; P = .02) and liver fat fraction (standard deviation scores, 0.34; 95% CI, 0.20-0.48; P < .001). Conclusions and Relevance Fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.

Fetal growth does not modify the relationship of infant weight gain with childhood adiposity and blood pressure in the Southampton women’s survey

“…Our findings differ from three studies from the "Generation R" cohort, which did observe interaction effects between infant weight gain and patterns of fetal weight gain (Gishti et al 2014;Toemen et al 2016;Vogelezang et al 2019). However, across the three studies, the interaction effects differed depending on the outcome.…”

“…Conversely, children who had "decelerated growth" during both gestation and infancy had a larger left ventricular mass (Toemen et al 2016). Finally, in the third study, Vogelezang et al (2019) observed that children who had either fetal growth deceleration or acceleration followed by accelerated infant growth displayed suboptimal adiposity profiles in childhood. As such, the overall conclusion from these studies is unclear.…”

“…The use of EFW provided us with a measure of prenatal growth that could be used in conjunction with infant weight gain and also enabled some comparison to the related studies from the "Generation R" cohort (Gishti et al 2014;Toemen et al 2016;Vogelezang et al 2019). The generation of EFW is, however, associated with error.…”

Neonatal adiposity may increase plasmatic cytokines

“…chronic noncommunicable diseases in the short-and medium-term and is additionally related to school-age adiposity [33]. In our neonates, AC was moderately correlated with an increase in their mothers' gestational weight (r = 0.45, p = 0.016), but not with P-BMI.…”

Early individual and family predictors of weight trajectories from early childhood to adolescence: results from the Millennium Cohort Study

“…Moreover, it has been proposed that both nutrient overabundance and scarcity during pregnancy and infancy lead to a metabolic programming that results in an increased obesity risk throughout the lifespan (40). In fact, in a longitudinal cohort in Rotterdam, individuals with fetal growth restriction followed by infant weight acceleration had higher visceral and liver adiposity than those with normal fetal and infant growth (41).…”