Evaluation of air-displacement plethysmography for body composition assessment in preterm infants

Roggero, Paola; Giannì, Maria Lorella; Amato, Orsola; Piemontese, Pasqua; Morniroli, Daniela; Wong, William W.; Mosca, Fabio

doi:10.1038/pr.2012.75

Cited by 79 publications

(81 citation statements)

References 18 publications

(28 reference statements)

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“…50 Data are not available in preterm infants at earlier postnatal ages because measuring the body composition of small infants is difficult, [51][52][53] particularly because of the high acuity of preterm infants in the clinical setting. New methods are promising 12,54 but not easily accessible. The first step to understanding these associations in preterm infants is to define a population reference for calculation of BMI percentiles and z scores.…”

Section: Discussionmentioning

confidence: 99%

BMI Curves for Preterm Infants

et al. 2015

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BACKGROUND AND OBJECTIVES: Preterm infants experience disproportionate growth failure postnatally and may be large weight for length despite being small weight for age by hospital discharge. The objective of this study was to create and validate intrauterine weight-for-length growth curves using the contemporary, large, racially diverse US birth parameters sample used to create the Olsen weight-, length-, and head-circumference-for-age curves.METHODS: Data from 391 681 US infants (Pediatrix Medical Group) born at 22 to 42 weeks' gestational age (born in 1998-2006) included birth weight, length, and head circumference, estimated gestational age, and gender. Separate subsamples were used to create and validate curves. Established methods were used to determine the weight-for-length ratio that was most highly correlated with weight and uncorrelated with length. Final smoothed percentile curves (3rd to 97th) were created by the Lambda Mu Sigma (LMS) method. The validation sample was used to confirm results. RESULTS:The final sample included 254 454 singleton infants (57.2% male) who survived to discharge. BMI was the best overall weight-for-length ratio for both genders and a majority of gestational ages. Gender-specific BMI-for-age curves were created (n = 127 446) and successfully validated (n = 126 988). Mean z scores for the validation sample were ∼0 (∼1 SD).CONCLUSIONS: BMI was different across gender and gestational age. We provide a set of validated reference curves (gender-specific) to track changes in BMI for prematurely born infants cared for in the NICU for use with weight-, length-, and head-circumference-for-age intrauterine growth curves. WHAT'S KNOWN ON THIS SUBJECT:Preterm infants experience disproportionate growth failure postnatally and may be large weight for length despite being small weight for age by hospital discharge. There is no routinely used measure to quantify and monitor disproportionate growth in the NICU.WHAT THIS STUDY ADDS: BMI differs across gender and gestational age. We provide a set of validated reference curves to track changes in BMI for prematurely born infants for use with weight-, length-, and head-circumference-for-age intrauterine growth curves.

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Section: Discussionmentioning

confidence: 99%

BMI Curves for Preterm Infants

et al. 2015

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“…Body composition was assessed using an air displacement plethysmography system (PEA POD Infant Body Composition System). A detailed description of the PEA POD's physical design, operating principles, validation, and measurement procedures is provided elsewhere (23,24). Briefly, the PEA POD assesses fat mass and fat-free mass by direct measurements of body mass and volume and application of a classic densitometric model in which percentage of body fat is calculated using body density and predetermined fat and fat-free mass density values.…”

Section: Growth and Body Composition Assessmentmentioning

confidence: 99%

Body composition in late preterm infants according to percentile at birth

et al. 2015

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Background:The data on body composition of late preterm infants, evaluated according to percentile at birth, are scarce. The study aimed to investigate body composition of late preterm infants, according to percentile at birth, and to compare their body composition with that of term newborns. Methods: A total of 122 (99 appropriate and 23 small for gestational age (SGA)) late preterm infants underwent growth and body composition assessment using an air displacement plethysmography system on the fifth day of life and at term. The reference group was composed of 42 healthy, term, breast-fed infants. results: At birth, appropriate and SGA late preterm infants had lower fat mass and fat-free mass indexes than term newborns. The fat mass and fat-free mass content increased significantly throughout the study, irrespective of percentile at birth. At term, fat mass index, but not fat-free mass index, was higher in both appropriate and SGA late preterm infants than in term newborns. conclusion: Late preterm infants, irrespective of their percentile at birth, show postnatal growth characterized by predominant fat mass accretion. The potential long-term health clinical implications of these findings need to be further elucidated. l ate preterm birth, defined as a birth that occurs between 34 0/7 and 36 6/7 weeks of gestation, has markedly increased during the past two decades, accounting for 70% of all preterm births (1). Late preterm infants have been recognized as a high-risk group due to an increased mortality and morbidity compared with full-term newborn infants (2). In addition, although late preterm birth has been associated with a rapid postnatal catch-up growth within the first months of life (3,4), growth faltering up to 5 y of age has also been reported (5). With regard to body composition, late preterm infants at termcorrected age show a higher fat mass but a lower fat-free mass than full-term infants (3,4).Early life has been recognized as a critical time window for metabolic programming. Hence, concern has arisen regarding the potential implications of these findings on the long-term health outcomes of late preterm infants. Indeed, both early growth pattern and body composition development appear to contribute to the programming process for disease risk in later life (6).While postnatal growth and body composition changes in very preterm infants have been widely investigated, considering percentile at birth (7,8), there is a paucity of data on body composition of late preterm infants, evaluated according to percentile at birth. The aim of our study was to investigate body composition changes from birth to term-corrected age in a cohort of late preterm infants, categorized according to percentile at birth, and to compare their body composition with that of full-term newborns. RESULTSGrowth and body composition at term-corrected age data were available for 122 late preterm infants whose basic characteristics at birth are shown in Table 1. As expected, appropriate for gestational age (AGA) late preterm infants we...

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“…A detailed explanation of the PEA POD's design, operating principles, validation, and measurement procedures is presented elsewhere (32)(33)(34)(35)(36). The PEA POD uses the principles of whole-body densitometry to derive fat and FFM values using body density, fat mass density (0.9007 g/ml), and known ageand sex-specific FFM density values (37); this technique has been validated in preterm infants (38).Using the integrated electronic scale of the PEA POD, a 20-s infant body mass measurement is followed by a 2 min infant body volume measurement in the test chamber. Body density is then computed from body mass and volume.…”

Section: Body Composition Assessmentmentioning

confidence: 99%