BMI Is a Better Body Proportionality Measure than the Ponderal Index and Weight-for-Length for Preterm Infants

Ferguson, Nicole; Grabich, Shannon C.; Olsen, Irene E.; Cantrell, Rebecca; Clark, Reese H.; Ballew, Wendy N; Chou, Jeffrey; Lawson, M. Louise

doi:10.1159/000480118

Cited by 19 publications

(25 citation statements)

References 11 publications

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“…PI increases linearly during the third trimester when fetuses experience substantial mass accumulation, which outpaces gains in length. Large cross-sectional studies have confirmed the direct relationship between PI and gestational age [44,45]. In this study, median PI in the lowest tertile was > 3 standard deviations below the mean PI for male and female neonates at term birth and represents a value below the 3rd percentile for 35-40 weeks gestation [45].…”

Section: Discussionsupporting

confidence: 64%

Proportionality at birth and left ventricular hypertrophy in healthy adolescents

Sawyer

Pollock

Gutin

et al. 2019

Early Human Development

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Background: Perinatal growth has important implications for cardiac development. Low birth weight is associated with cardiovascular (CV) events and mortality, and animal studies have shown that fetal growth restriction is associated with cardiac remodeling in the perinatal period leading to a permanent loss of cardiomyocyte endowment and compensatory hypertrophy. Aims: To determine associations of birthweight (BW) and multiple proportionality indexes (body mass index (BMI); weight/length 2 and Ponderal index (PI); weight/length 3) at birth on one hand, with left ventricular (LV) structure and function during adolescence. Subjects: 379 healthy adolescents aged 14-18 years in Augusta, Georgia. Outcome measures: LV structure and function parameters, including intraventricular septal thickness in diastole (IVSd), LV internal dimension in diastole (LVIDd), LV internal diameter in systole (LVIDs), LV posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), midwall fractional shortening (MFS), and ejection fraction, were assessed by echocardiography. Results: When associations of birthweight, birth BMI, and birth PI with LV structure and function parameters were separately evaluated with linear regression adjusting for age, sex, race, Tanner stage, socioeconomic status, and physical activity, significant positive associations of BW with LVIDd (P = 0.004), birth BMI with LV mass index (P = 0.01), and birth PI with IVSd (P = 0.02), LVPWd (P = 0.03), and LV mass index (P = 0.002) were identified. When LV structure and function parameters were compared across PI tertiles, a significant U-shaped trend for LV mass index (P quadratic = 0.04) was identified.

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Section: Discussionsupporting

confidence: 64%

Proportionality at birth and left ventricular hypertrophy in healthy adolescents

Sawyer

Pollock

Gutin

et al. 2019

Early Human Development

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“…Ponderal index has been the traditional measure used to assess proportionality at birth and to distinguish between asymmetrical and symmetrical types of intrauterine growth restriction [69]. More recently, BMI has been reported to be more appropriate to assess body proportionality than either weight-for length ratio or ponderal index [70].…”

Section: Anthropometrymentioning

confidence: 99%

Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU

2019

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A practical approach for nutritional assessment in preterm infants under intensive care, based on anthropometric measurements and commonly used biochemical markers, is suggested. The choice of anthropometric charts depends on the purpose: Fenton 2013 charts to assess intrauterine growth, an online growth calculator to monitor intra-hospital weight gain, and Intergrowth-21st standards to monitor growth after discharge. Body weight, though largely used, does not inform on body compartment sizes. Mid-upper arm circumference estimates body adiposity and is easy to measure. Body length reflects skeletal growth and fat-free mass, provided it is accurately measured. Head circumference indicates brain growth. Skinfolds estimate reasonably body fat. Weight-to-length ratio, body mass index, and ponderal index can assess body proportionality at birth. These and other derived indices, such as the mid-upper arm circumference to head circumference ratio, could be proxies of body composition but need validation. Low blood urea nitrogen may indicate insufficient protein intake. Prealbumin and retinol binding protein are good markers of current protein status, but they may be affected by non-nutritional factors. The combination of a high serum alkaline phosphatase level and a low serum phosphate level is the best biochemical marker for the early detection of metabolic bone disease.

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“…Body proportionality is usually measured as an index of weight/length power ; however, no consensus exists about the ideal body proportionality index (PRI) to evaluate NB growth and nutritional status by GA applicable in large‐scale epidemiologic studies (Cole, Henson, Tremble, & Colley, 1997; Ferguson et al, 2018; Olsen et al, 2015; Villar et al, 2017). In 1971, Benn proposed the “criteria of optimality” for a “good” index of obesity: (a) it should be highly correlated with measures of relative adiposity and (b) its distribution should be independent from length (Benn, 1971) or have r ≈ 0 (Olsen et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Proportionality indices, geographic altitude, and gestational age in newborns from Jujuy, Argentina

Martínez

Revollo

Alfaro

et al. 2020

American J Hum Biol

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Background There are several different proportionality indices (PRIs) to evaluate size at birth by gestational age (GA). Yet, the explanatory power of alternative PRIs has not been evaluated in highland (HL) populations. Aim Evaluate the relative utility of three PRIs, weight to length ratio (W/L), body mass index (BMI), and ponderal index (PI), for assessing nutritional status in newborns (NBs) from highland (HL ≥ 2000 m) and lowland (LL < 2000 m) regions of the Jujuy Province of Argentina. Subjects and methods Births were registered by the Ministry of Health (Jujuy, 2009‐2014). Data were grouped according to HL and LL altitude groups based on of maternal residence. The main outcome measures were the PRIs W/L ratio, BMI, and PI. Percentiles were generated by the LMS method and compared with references. ANOVAs and Pearson correlations were used to examine the relationship between outcome measures with weight and length by altitude, sex, and GA. Results In both altitude zones, W/L and BMI increased with GA, while PI stabilized between 37th and 42th weeks. The LL sample had significantly higher values for all the PRIs from the 37th week of GA. In the HL sample, the 50th percentiles for all three PRIs were lower than the reference. Regardless of GA and altitude level, BMI showed the lowest correlation with length and the higher with the weight. Conclusion The HL sample of term NBs had lower values for all PRIs compared to their LL counterparts. In both altitude zones, the BMI is the preferred PRI to evaluate the nutritional status.

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BMI Is a Better Body Proportionality Measure than the Ponderal Index and Weight-for-Length for Preterm Infants

Cited by 19 publications

References 11 publications

Proportionality at birth and left ventricular hypertrophy in healthy adolescents

Proportionality at birth and left ventricular hypertrophy in healthy adolescents

Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU

Proportionality indices, geographic altitude, and gestational age in newborns from Jujuy, Argentina

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