Novel noninvasive anthropometric measure in preterm and full-term infants: normative values for waist circumference:length ratio at birth

Abstract

Background: Waist circumference:length ratio (WLR) and ponderal index (PI) appear to be useful markers of visceral and total adiposity, respectively. However, there are no normative birth data across the full range of gestational ages. Methods: In this retrospective cohort study of 500 preterm and 1,426 full-term infants, born in 1998 and 2008 at three military hospitals, the percentile growth curves for WLR and PI were calculated. There were no sex differences, and results were combined to obtain values from 26 to 42 wk gestation. results: Between 26 and 42 wk gestation, median birth WLR increased from 0.55 to 0.62, and median PI increased from 21.1 to 25.6. The adjusted mean WLR at birth among infants born <34 wk increased from 0.55 in 1998 to 0.58 in 2008 (P = 0.048), suggesting that early-preterm infants born in 2008 had greater abdominal adiposity than those born in 1998. conclusion: We report normative birth data for WLR and PI in preterm and full-term infants by gestational age and sex. WLR and PI may be useful as clinical markers of visceral and overall adiposity. In conjunction with other anthropometric measures, WLR and PI may be useful to monitor postnatal nutrition and growth and assess risk for later obesity and cardiometabolic disorders. Many studies have shown that excess body adiposity, especially visceral adiposity, increases the risk for later cardiometabolic disorders. Measuring the waist circumference (WC) (1) has been used in adults, adolescents, and children as a simple and inexpensive population-based strategy for a clinical practice-based estimate of visceral adiposity (1). Elevated WC was associated with diabetes, coronary artery disease, morbidity, and mortality in adult North American, Asian, and European populations (2-4). WC has been shown to correlate with the risk of type 2 diabetes, in some cases better than weight, height, body mass index (BMI), or skinfold thickness (5). The ratio of standing height to WC has been utilized in some studies to normalize for age, sex, and race/ethnicity. The waist circumference:height ratio (WHtR) was closely associated with coronary risks such as hypertension, hyperglycemia, hypertriglyceridemia, hypercholesterolemia, and lower levels of high-density lipoprotein (3). WHtR was a better predictor of metabolic syndrome than BMI in Mexican children aged 6-12 y (6). Data for infants, however, are lacking. There are some very limited population-based norms in infants born full term for WC and waist circumference:length ratio (WLR) based on supine length, but there are no birth data in infants born preterm (7,8).In current practice, neonatologists aim to achieve postnatal growth rates comparable to intrauterine growth based on estimated gestational age (EGA) and weight (9). But weight by itself tells only a little about the overall body composition. The BMI has been used to evaluate growth and as a surrogate indicator of obesity. However, the BMI has not been utilized in infants, and it does not reliably distinguish between growth in lean and that in fat...

Maternal low glycaemic index diet, fat intake and postprandial glucose influences neonatal adiposity – secondary analysis from the ROLO study

“…Although maternal smoking during pregnancy is associated with reduced birth weight, length and relatively unchanged ponderal index in the literature [55,56], we were unable to identify any studies that had measured waist:length ratio at birth in relation to maternal smoking status. The only studies identified that had measured waist:length ratio at birth were from the same group and involved creation of normative waist:length centile charts at birth [57]. The increased waist:length ratio observed in the off-spring of smokers in this study appears to reflect the reduced height also observed and likely indicates that, while birthweight is not increased, central and visceral adiposity may be, increasing the risk of metabolic syndrome in later life.…”

Association of prematurity with the development of infantile hypertrophic pyloric stenosis

“…Bottle-feeding status, inpatient medication exposures, and maternal smoking data were unavailable for the present study. Of note, previous studies of preterm infants in military families have reported low rates of maternal smoking (27). Additionally, military families have access to low cost or free healthcare, higher rates of maternal education, and lower selfreported fetal exposure to alcohol or drug use.…”

“…The adjusted odds ratio for prematurity was 1.26 (95% CI 1.08-1.46). The median (interquartile range (IQR)) chronological age at presentation was 40 d (30-56) in preterm infants vs. 33 d (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) in full term (P < 0.001). Median postmenstrual age at presentation was 42 wk in preterm infants (40-42) vs. 45 wk (44-46) in full term (P < 0.001).…”

Differential impact of maternal and paternal ethnicity on the pattern of fat distribution in infants at age 3 months

“…The sum of all SFT was calculated as a measurement of total adiposity. To further evaluate central fat deposition, two other parameters were calculated: (i) ratio of abdominal circumference to length , and (ii) ratio of subscapular to triceps SFT .…”