Height at three months can indicate overweight at two years in catch-up growth of small for gestational age infants

Shi Chen,Linjie Wang,Yu Jiang,Zeyu Liu,Qing Wang,Jianqiang Li,Huijuan Zhu,Fengying Gong,Hongbo Yang,Chengsheng Yan,Hui Pan

doi:10.1038/s41598-018-29698-8

Abstract

This study aimed to find an indicator at three months to predict overweight and short stature at two years in small for gestational age (SGA) infants. A total of 468 SGA infants and 4642 appropriate for gestational age (AGA) infants were included. Weight and height were measured at birth, three months and two years. Logistic regression and receiver operating characteristic (ROC) curves were performed for the catch-up growth. As compared to AGA infants, the weight of SGA infants was lower and the length/height was shorter at birth, three months, and two years. The weight of the catch-up group was significantly greater at birth and two years. The length/height of the catch-up group was greater at three months and two years. Trajectories of weight standard deviation score (SDS) and height SDS showed that the overweight group (BMI over the 85th percentile) had a shorter length/height SDS but a higher rate of the change in weight SDS during catch-up growth. The multivariate logistic regression indicated that that height at three months was an independent factor for prediction of catch-up growth at two years. The area under curve (AUC) was 0.801 with the 95% confidence interval (CI) from 0.726 to 0.876. Therefore, height at three months can predict overweight at two years.

Highlights

Birth weight is an important indicator of neonatal health[1,2]
We investigated the trajectories of postnatal growth of small for gestational age (SGA) subjects from birth to the age of two years in order to detect early indicators for overweight of SGA subjects during catch-up growth and prevent overweight/obesity in later life
The results suggested that anthropometric features at three months were strongly related to those at the age of two years, which may be utilized as a predictor for overweight and short stature in later life

Summary

Introduction

Birth weight is an important indicator of neonatal health[1,2]. Low birth weight can be expressed as small for gestational age (SGA), which is generally defined as the birth weight under 2 standard deviation (SD) below the mean or less than the 3rd or 10th percentile for the gestational age[3]. SGA infants have a higher incidence of short stature in adulthood[5]. About 14% of short stature in adulthood was due to SGA at birth[6]. SGA infants faced long-term disadvantages and were at high metabolic risk[3,20]. This study was designed as a two-year observational study to examine the catch-up growth trajectory of SGA infants in order to find a possible indicator at three months for the prediction of overweight and short stature at two years. This could help to detect and prevent overweight in later life

Objectives

Methods

Results

Conclusion