Gestational age-dependency of height and body mass index trajectories during the first 3 years in Japanese small-for-gestational age children

Abstract

Gestational age (GA) is thought to affect height growth in small-for-gestational age (SGA) children. However, the GA-specific trajectories in body mass index (BMI) and early appearances of adiposity rebound (AR) have not been fully investigated in a cohort of Japanese SGA children. A longitudinal cohort study was conducted with 1063 SGA children born in Kobe, Japan, with sufficient records from birth to 3 years of age. Subjects were divided into subgroups based on GA: 39–41 weeks GA (n = 723), 37–38 weeks GA (n = 256), 34–36 weeks GA (n = 62), and <34 weeks GA (n = 22). Height and BMI were assessed at 4 months, 9 months, 1.5 years, and 3 years of age. The catch-up rate for height was GA-dependent. Most children with 39–41 weeks GA (91%) caught up by 4 months of age; however, lower GA was associated with a slower elevation in the catch-up rate. The BMI trajectory during the first 3 years was also GA-dependent, with a change in GA dependency at a boundary of 37 weeks GA. Approximately 7% of SGA children had already developed AR before 3 years of age. In conclusion, growth patterns during infancy and early childhood in SGA children differ depending on GA.

Height at three months can indicate overweight at two years in catch-up growth of small for gestational age infants

“…Moreover, metabolic syndrome including type 2 diabetes mellitus and cardiovascular disease were reported to be associated with SGA subjects in adulthood 17 – 19 . Thus, SGA infants faced long-term disadvantages and were at high metabolic risk 3 , 20 . Despite these findings indicating a relationship between SGA and metabolic risks, the underlying mechanism remains largely unknown 21 .…”

Body mass index trajectories and adiposity rebound during the first 6 years in Korean children: based on the National Health Information Database, 2008-2015

“…Second, the number of subjects in the LBW and VLBW groups was small, relative to those in the non-LBW group in this study; therefore, this may attenuate the differences in AR timing. Third, gestational age is also an important factor for catch-up growth with a boundary of 37 weeks gestational age [10], but data of gestational period was unavailable in this study.…”

“…The best way is to trace an individual's adiposity plot through visual inspection [2,35]; however, most often, there is insufficient frequency of measured data to allow the use of this method. To compensate for this problem, various statistical approaches [5,7,[35][36][37] or the researchers' own definitions [10,27,38] were used. Second, definitions of early AR also varied according to literatures.…”

“…Therefore, we determined the timing of AR at which the lowest BMI occurred as in the previous study [5]. The definition of early AR also varied according to studies [2,10]. In this study, we defined subgroups according to the timing of AR as follows: early AR, timing of AR before 45 months of age (Exam-V); moderate AR, timing of AR at 57 months of age (Exam-VI); and late AR, no AR until 69 months of age (Exam-VII).…”

“…Catch-up growth, which is attained by a period of supra-normal growth velocity in SGA children, is essential to gain a normal growth, but an emphasis on adequate nutritional support during early infancy is important not to gain overgrowth too rapidly. A recent study revealed that gestational age per se was an independent factor for the timing of AR in SGA children [10]; all together, these suggested that we should look at the BMI trajectory of SGA children more carefully.…”