Growth and Cardiovascular Risk Factors in Prepubertal Children Born Large or Small for Gestational Age

Abstract

Background: Both large and small birth sizes are associated with an increased risk of developing cardiovascular and metabolic problems later in life. We studied whether such associations can be observed at prepubertal age. Methods: A cohort of 49 large (LGA), 56 appropriate (AGA), and 23 small for gestational age (SGA)-born children (age range 5-8 years) were studied. Being born SGA, AGA, or LGA was the exposure, and being overweight at prepubertal age was the main outcome. Blood pressure measurements, laboratory parameters, and whole-body dual-energy X-ray absorptiometry were secondary outcomes. Results: The LGA-born children were significantly taller than the AGA controls (p = 0.03), and the SGA children were lighter and shorter compared to the AGA (p = 0.002 and 0.001) and LGA children (p < 0.001). The mean plasma glucose was higher in the LGA than in the SGA group (p = 0.006). Being born LGA (OR 3.82) and the ponderal index Z-score at birth (OR 4.24) were strong predictors for being overweight or obese in childhood. Conclusion: The children born LGA remained taller and heavier than those born AGA or SGA in mid-childhood, and they had a higher body mass index and body fat percentage than the SGA-born children. The differences in other cardiometabolic risk factors were minimal between the birth size groups.