Early body composition changes are associated with neurodevelopmental and metabolic outcomes at 4 years of age in very preterm infants

Pfister, Katie M.; Zhang, Lei; Miller, Neely C.; Ingolfsland, Ellen C.; Demerath, Ellen W.; Ramel, Sara E.

doi:10.1038/s41390-018-0158-x

Cited by 59 publications

(57 citation statements)

References 38 publications

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“…The current analysis extends previous findings by confirming that the relationships between higher amounts of FFM and higher standardized test scores persist out to 24 months of age. However, the current study differed from some of the previous studies in that gains in FFM after term were no longer associated with neurodevelopmental outcomes [1,3,4], suggesting a potentially smaller window of time to intervene with regards to optimizing FFM gains with the goal of improving later neurodevelopment.…”

Section: Discussioncontrasting

confidence: 95%

“…Our study also confirmed the findings of several other studies related to the positive relationship between FFM gains during hospitalization and long-term neurodevelopment. These previous studies also found that gains in FFM, but not FM, prior to hospital discharge, during a time of rapid brain growth and development, were associated with faster speed of brain processing in infancy and at preschool age [1,4], higher standardized test scores at 12 months of age [2], higher scores on the ages and stages questionnaire at two years of age [22] and larger brain volumes [5]. The current analysis extends previous findings by confirming that the relationships between higher amounts of FFM and higher standardized test scores persist out to 24 months of age.…”

Section: Discussionmentioning

confidence: 71%

“…Fat-free mass (FFM) gains are closely linked to brain development and are thus important growth parameters for the study of nutritional and physiological stressors on the preterm infant. Faster gains in FFM throughout hospitalization, as well as after hospital discharge, have been associated with improved neurocognitive outcomes, including higher cognitive and motor scores on standardized testing at 12 months corrected age for prematurity (CA), faster speed of processing in infancy and at preschool age and larger brain volumes at term CA [1][2][3][4][5]. Research into strategies that increase FFM gains are needed in order to optimize neurodevelopment without increasing metabolic risk.…”

Section: Introductionmentioning

confidence: 99%

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Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes

et al. 2020

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Preterm infants have altered body composition compared to term infants, which impacts both neurodevelopment and metabolic health, but whether increased dietary intake during hospitalization, independent of illness, may improve body composition is unknown. This prospective, longitudinal study (n = 103) measured fat-free mass (FFM) and percent body fat (%BF) at discharge and four months corrected age for prematurity (CA) in very low birth weight (VLBW) preterm infants. Markers of illness and macronutrient intakes (protein and caloric) were recorded. Bayley Scales of Infant Development-III (BSID) were administered at 12 and 24 months of age in a subset of these infants (n = 66 and n = 50 respectively). Body composition z-scores were calculated using recently developed reference curves. Linear regression was used to test the associations between clinical factors and body composition z-scores, as well as z-scores and BSID scores. Increased calories and protein received in the first week after birth and protein intake throughout hospitalization were associated with increased FFM z-scores at discharge, but not with %BF z-scores. After adjustment for both early acute and chronic illness, associations of nutrient intake with FFM z-score remained unchanged. FFM z-scores at discharge were positively associated with scores on the BSID at 12 and 24 months CA. In conclusion, increased energy and protein intakes both early in hospitalization and across its entire duration are associated with higher FFM at discharge, a key marker for organ growth and neurodevelopment in the VLBW neonate. Optimizing caloric intake, irrespective of illness is critical for enhancing body composition, and by extension, neurodevelopmental outcomes for preterm infants.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes

et al. 2020

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“…Improved early growth is associated with improved neurodevelopmental outcomes amongst preterm infants [15][16][17]. Specifically, improved fatfree mass (FFM) gains in children born prematurely have been associated with improved neurodevelopment at 12 months of age and faster speed of processing at 4 months and 4 years of age [18][19][20]. To our knowledge, no published study has reported associations between body composition and neurodevelopmental outcomes in children with CGIAs.…”

Section: Introductionmentioning

confidence: 99%

Body composition and cognition in preschool-age children with congenital gastrointestinal anomalies

Plummer

Wang

Larson‐Nath

et al. 2019

Early Human Development

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Background: Children with congenital gastrointestinal anomalies (CGIAs) experience multiple stressors while hospitalized in neonatal intensive care units during an essential time of growth and development. Early stress and inadequate nutrition are linked to altered growth patterns and later neurodevelopmental delays. In other at-risk populations, improved fat-free mass (FFM) accretion is associated with improved cognitive outcomes. Objective: To determine if body composition is associated with cognitive function in preschoolage children with CGIAs.

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“…Numerous studies have also associated low birth weight with high SBP in children, adolescents and adults Shiell, 1996, Nilsson et al, 1997). A recent study found early FM gains in very preterm infants to be associated with higher blood pressure at 4 years of age (Pfister et al, 2018). There is substantial evidence to suggest that accelerated postnatal catch-up growth in childhood is also associated with later increased SBP (Huxley et al, 2000).…”

Section: Blood Pressurementioning

confidence: 99%

Infant body composition as a predictor of childhood obesity, cardiovascular risk and inflammatory markers

Ratnasingham¹

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Background Childhood obesity is a growing epidemic associated with increased cardiometabolic disease risk in later life. Early detection and effective intervention are critical for preventing later obesity onset. Early life plays a key role in programming the development of later diseases. While birth weight is associated with poor health outcomes in later life, early body composition (fat mass [FM] vs. fat-free mass [FFM]) may be a better predictor. Aims The overarching aim of this study was to determine whether infant body composition is associated with later adverse health risk in childhood. Specifically, this study aimed to determine: (1) whether infant body composition is a better predictor of childhood obesity/cardiovascular risk/inflammatory markers than birth weight; and if so, (2) which infant body composition factors best predict childhood obesity/cardiovascular risk/inflammatory markers; and (3) what other early life and childhood factors are associated with childhood obesity/cardiovascular risk/inflammatory markers. It was hypothesised that increased infant adiposity would be a better predictor of later adverse health risk in childhood than birth weight. Methods This was an observational follow-up study of 131 children recruited as newborns at the Royal Brisbane and Women's Hospital (RBWH) between 2007 and 2010. Body composition had previously been measured by air displacement plethysmography (ADP) using the PEA POD ® Infant Body Composition System at four different timepoints during infancy: birth, 6 weeks, 3 months and 4.5 months of age. Maternal risk factors (e.g. pre-pregnancy body mass index [BMI] and gestational diabetes mellitus [GDM]) and infant feeding information were also recorded. During the childhood follow-up visit at 8 to 11 years of age, body composition was measured by ADP using the BOD POD ® Body Composition System to assess obesity. Childhood cardiovascular risk was assessed using multiple markers: carotid intima-media thickness (cIMT), retinal vasculature parameters (mainly arteriole-to-venule ratio [AVR]) and blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Urine samples were collected and assayed for four inflammatory markers: tumour iii necrosis factor-α (TNF-α), interleukin-6 (IL-6), α1-acid glycoprotein (AGP) and endothelin-1 (ET-1). Potential confounding factors including diet, physical activity and socioeconomic status (SES) were also recorded. Backward stepwise multiple regression analyses were used to identify significant predictors of childhood outcome variables. Statistical significance was accepted at p < 0.05. Results There was no association between childhood percentage fat (%Fat) and either birth weight or birth weight z-score in this cohort. Higher %Fat at 6 weeks was a significant predictor of increased childhood %Fat, as were higher maternal pre-pregnancy BMI and earlier exposure to formula feeding. For every additional 1% in %Fat at 6 weeks, childhood %Fat increased by 0.4%. For every 2.5 kg/m 2 increase in maternal pre-pregnancy...

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Early body composition changes are associated with neurodevelopmental and metabolic outcomes at 4 years of age in very preterm infants

Cited by 59 publications

References 38 publications

Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes

Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes

Body composition and cognition in preschool-age children with congenital gastrointestinal anomalies

Infant body composition as a predictor of childhood obesity, cardiovascular risk and inflammatory markers

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