Abstract
The purpose of this systematic review and meta-analysis of the literature was to analyze and evaluate the impact of prematurity and accelerated weight gain on the risk of childhood and adolescent obesity. CINAHL, Embase, PubMed, and Web of Science databases were searched until December 2019 which yielded 19 studies with a total of 169,439 children enrolled were systematically reviewed. The results revealed that preterm infants had a greater likelihood of childhood obesity (defined as BMI ≥95th percentile for age-sex), than term infants (OR = 1.19, 95% CI [1.13, 1.26]). However, no difference of childhood obesity was found between “small for gestational age”(SGA) and “appropriate for gestational age”(AGA) among preterms. Accelerated weight gain (defined as weight gain velocity during first two years after birth) significantly increased the likelihood of subsequent childhood obesity among preterms (aOR = 1.87, 95% CI [1.57, 2.231]). In conclusion, accelerated weight gain at infancy among preterm children may be a critical contributor to obesity in later life. Establishing optimal growth trajectories and timely referral to health care providers may be of clinical importance.
Highlights
The rapid increase of obesity in children and adolescents, a worrisome trend, has emerged as a public health issue in both developed and developing countries [1,2,3]
The characteristics of the studies included in the review and their criteria for defining obesity are summarized in Table 1.(Table 1)
Our results revealed that premature infants had a greater likelihood of childhood obesity at age 6 to 16than infants born at term.In addition, accelerated weight gain in preterm infants significantly increased the likelihood of childhood obesity at age 8 to 11
Summary
The rapid increase of obesity in children and adolescents, a worrisome trend, has emerged as a public health issue in both developed and developing countries [1,2,3]. Childhood obesity is associated with increased morbidity and mortality in adulthood [4, 5]. Several factors have been shown to increase the risk of childhood obesity, including prematurity, small or large for gestational age (GA), small or large birth weight, and a family history of obesity-related diseases [6,7,8,9,10]. According to the WHO, the prevalence of preterm birth ranges from 5% to 18%, including approximately 12% in lower-income countries and 9% in higher-. The World Health Organization (WHO) defines prematurity as “born alive before 37 weeks of pregnancy.” According to the WHO, the prevalence of preterm birth ranges from 5% to 18%, including approximately 12% in lower-income countries and 9% in higher-
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