Associations of Fetal and Infant Weight Change With General, Visceral, and Organ Adiposity at School Age

Suzanne Vogelezang,Liza Toemen,Edwin H. G. Oei,Susana Santos,Janine F. Felix,Vincent W. V. Jaddoe

doi:10.1001/jamanetworkopen.2019.2843

Abstract

ImportanceBoth fetal and infant growth influence obesity later in life. The association of longitudinal fetal and infant growth patterns with organ fat is unknown.ObjectiveTo examine the associations of fetal and infant weight change with general, visceral, and organ adiposity at school age.Design, Setting, and ParticipantsThis cohort study was embedded in the Generation R Study, a population-based prospective cohort study in Rotterdam, the Netherlands. Pregnant women with a delivery date between April 2002 and January 2006 were eligible to participate. Follow-up measurements were performed for 3205 children. Data analysis of this population was performed from July 26, 2018, to February 7, 2019.ExposuresFetal weight was estimated in the second and third trimester of pregnancy. Infant weight was measured at 6, 12, and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change in standard deviation scores greater than 0.67 between 2 ages.Main Outcomes and MeasuresVisceral fat index, pericardial fat index, and liver fat fraction were measured by magnetic resonance imaging.ResultsThe sample consisted of 3205 children (1632 girls [50.9%]; mean [SD] age, 9.8 [0.3] years). Children born small for gestational age had the lowest median body mass index compared with children born appropriate for gestational age and large for gestational age (16.4 [90% range, 14.1-23.6] vs 16.9 [90% range, 14.4-22.8] vs 17.4 [90% range, 14.9-22.7]). Compared with children with normal fetal and infant growth (533 of 2370 [22.5%]), those with fetal weight deceleration followed by infant weight acceleration (263 of 2370 [11.1%]) had the highest visceral fat index (standard deviation scores, 0.18; 95% CI, 0.03-0.33; P = .02) and liver fat fraction (standard deviation scores, 0.34; 95% CI, 0.20-0.48; P < .001).Conclusions and RelevanceFetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.

Highlights

Childhood body fat may be associated with patterns of fetal and infant weight change.[1,2,3] Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration.[2,4,5] A previous study reported that fetal growth deceleration followed by infant growth acceleration may lead to an adverse body fat distribution at age 6 years.[1]
Children born small for gestational age had the lowest median body mass index compared with children born appropriate for gestational age and large for gestational age (16.4 [90% range, 14.1-23.6] vs 16.9 [90% range, 14.4-22.8] vs 17.4 [90% range, 14.9-22.7])
Compared with children with normal fetal and infant growth (533 of 2370 [22.5%]), those with fetal weight deceleration followed by infant weight acceleration (263 of 2370 [11.1%]) had the highest visceral fat index and liver fat fraction

Summary

Introduction

Childhood body fat may be associated with patterns of fetal and infant weight change.[1,2,3] Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration.[2,4,5] A previous study reported that fetal growth deceleration followed by infant growth acceleration may lead to an adverse body fat distribution at age 6 years.[1] Studies using longitudinal growth data showed that both infant peak weight velocity (PWV), reflecting the greatest infant weight change, and body mass index at adiposity peak (BMIAP), reflecting body mass index (BMI) reached at adiposity peak, may affect childhood adiposity.[6,7,8,9] Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic phenotypes.[10,11,12,13] Identification of early-life growth patterns affecting specific body fat measures from childhood onward may contribute to future prevention strategies

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