Consequences of Being Born Small for Gestational Age on Body Composition: An 8-Year Follow-Up Study

Abstract

Increased fat mass has been reported in children and adults born small for gestational age (SGA). However, the progression of anthropometric parameters have been poorly documented in SGA adults. We hypothesized that SGA individuals would remain susceptible to gain more fat when adults beyond the period of postnatal catch-up growth. From a community-based cohort, 389 subjects born full-term SGA (body weight < 10th percentile) were compared with 462 subjects born appropriate for gestational age (25th < body weight < 75th percentile). Anthropometric parameters were measured at 22 and 30 yr as well as body composition (by multifrequency bioelectrical impedancometry and skinfold thickness) at 30 yr. Both groups gained weight, body mass index (BMI), and waist circumference. Progression of BMI was significantly greater in SGA (1.8 +/- 2.6 vs. 1.4 +/- 2.6 kg/m(2); P = 0.03). At 30 yr, the proportion of obese individuals was significantly increased in SGA (12.1 vs. 6.5%; P = 0.02), and percent body fat was significantly higher (23.5 +/- 8.7 vs. 21.9 +/- 8.0%; P = 0.01), the observation of which was confirmed by skinfold measures. Similarly, waist circumference gain was significantly greater in SGA (6.4 +/- 7.6 vs. 5.5 +/- 7.9, P = 0.04 when adjusted for gender and age). Over 8-yr follow-up, adults born SGA gained more BMI than appropriate for gestational age, resulting in greater fat mass with more abdominal fat. These data suggest that the consequences of fetal growth restriction on body composition are evolving beyond the period of early postnatal catch-up.