Anthropometry and body composition of preemies at term age and term age weight

Authors

  • Letícia Duarte VILLELA Fundação Oswaldo Cruz
  • Fernanda Valente MENDES SOARES Fundação Oswaldo Cruz
  • Andrea Dunshee de ABRANCHES Fundação Oswaldo Cruz
  • Saint-Clair GOMES JUNIOR Fundação Oswaldo Cruz
  • Maria Dalva Barbosa Baker MÉIO Fundação Oswaldo Cruz
  • Maria Elisabeth Lopes MOREIRA Fundação Oswaldo Cruz

Keywords:

Anthropometry, Body composition, Infant, premature, Infant, newborn

Abstract

Objective
To analyze growth and body composition of preemies at term gestational age and when they reach a weight of 3.0 to 3.5 kg.

Methods
This longitudinal study was conducted at Instituto Fernandes Figueira, Rio de Janeiro, and included 39 preemies with very low birth weight. Anthropometric measurements and bioelectrical impedance analysis were performed in 5 occasions: days 1 and 7 after birth; at birth weight recovery; at term-corrected gestational age; and at around three weeks of corrected gestational age (age needed to reach a weight of 3.0 to 3.5 kg). A reference group comprising 32 term newborns, appropriate for gestational age, was evaluated at day 2 after birth. Growth restriction was defined as a Z-score below -2 for weight, length, and head circumference.

Results
At term age, 71.8% of the preemies presented growth restriction for weight, 61.5% for length, and 25.6% for head circumference. When the preemies reached three weeks of corrected gestational age, triceps skinfold thickness and abdominal circumference were greater than those of the reference group, and length and percent of total body water were lower.

Conclusion
The anthropometric profile and total body water of preemies were different from those of term newborns, suggesting fat deposition. There was catch up growth between term age and three weeks of corrected gestational age, which was more evident for head circumference and weight.

References

Uauy R, Koletzko B. Defining the nutritional needs of preterm infants. In: Koletzko B, Poindexter B, Uauy R. Nutritional care of preterm infants: Scientific basis and practical guidelines. World Review of Nutrition and Dietetics. Basel (CH): Karger; 2014.

Belfort MB, Gillman MW, Buka SL, Casey PH, McCormick MC. Preterm infant linear growth and adiposity gain: Trade-offs for later weight status and intelligence quotient. J Pediatr. 2013; 163(6):1564-9. http://dx.doi.org/10.1016/j.jpeds. 2013.06.032

Ehrenkranz RA, Dusick AM, Vohr BR, Wright LL, Wrage LA, Poole WK. Growth in neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatrics. 2006; 117(4):1253-61. http:// dx.doi.org/10.1542/peds.2005-1368

American Academy of Pediatrics Committee on Nutrition. Nutritional needs of low-birth-weight infants. Pediatrics. 1985; 75(5):976-86.

Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al. Enteral nutrient supply for preterm infants: Commentary from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010; 50(1):85-91. http://dx.doi.org/10.1097/MPG.0b013e3181a daee0

Embleton ND, Simmer K. Practice of parenteral nutrition in VLBW and ELBW infants. In: Koletzko B, Poindexter B, Uauy R. Nutritional care of preterm infants: Scientific basis and practical guidelines. World Review of Nutrition and Dietetics. Switzerland: Karger; 2014.

Ehrenkranz RA, Younes N, Lemons JA, Fanaroff AA, Donovan EF, Wright LL, et al. Longitudinal growth of hospitalized very low birth weight infants. Pediatrics. 1999; 104(2 Pt. 1):280-9.

Horbar JD, Ehrenkranz RA, Badger GJ, Edwards EM, Morrow KA, Soll RF, et al. Weight growth velocity and postnatal growth failure in infants 501 to 1500 grams: 2000-2013. Pediatrics. 2015; 136(1):e84-92. http://dx.doi.org/10.1542/peds.2015-0129

Ehrenkranz RA. Early, aggressive nutricional management for very low birth weight infants: What is the evidence? Semin Perinatol. 2007; 31(2):48-55. http://dx.doi.org/10.1053/j.semperi. 2007.02.001

Simon L, Frondas-Chauty A, Senterre T, Flamant C, Darmaun D, Rozé JC. Determinants of body composition in preterm infants at the time of hospital discharge. Am J Clin Nutr. 2014; 100(1):98-104. http://dx.doi.org/10.3945/ajcn.113.080945

Martin CR, Brown YF, Ehrenkranz RA, O’Shea TM, Allred EN, Belfort MB, et al. Nutritional practices and growth velocity in the first month of life in extremely premature infants. Pediatrics. 2009; 124(2):649-57. http://dx.doi.org/10.1542/peds. 2008-3258

Mathai S, Derraik JGB, Cutfield WS, Dalziel SR, Harding JE, Biggs J, et al. Increased adiposity in adults born preterm and their children. PLoS ONE. 2013; 8(11):e81840. http://dx.doi.org/10.1371/ journal.pone.0081840

Leunissen RWJ, Kerkhof GF, Stijnen T, Hokken Koelega ACS. Effect of birth size and catch-up growth on adult blood pressure and carotid intima media thickness. Horm Res Paediatr. 2012; 77(6):394-401. http://dx.doi.org/10.1159/0003 38791

Kerkhof GF, Hokken-Koelega ACS. Rate of neonatal weight gain and effects on adult metabolic health. Nat Rev Endocrinol. 2012; 8(11):689-92. http://dx. doi.org/10.1038/nrendo.2012.168

Modi N, Thomas EL, Harrington TAM, Uthaya S, Doré CJ, Bell JDB. Determinants of adiposity during preweaning postnatal growth in appropriately growth and growth-restricted term infants. Pediatr Res. 2006; 60(3):345-8. http://dx.doi.org/10.1203/ 01.pdr.0000232732.93000.52

Uthaya S, Thomas EL, Hamilton G, Doré CJ, Bell J, Modi N. Altered adiposity after extremely preterm birth. Pediatr Res. 2005; 57(2):211-5. http:// dx.doi.org/10.1203/01.PDR.0000148284.58 934.1C

Barker DJ. The origins of the developmental origins theory. J Intern Med. 2007; 261(5):412-7. http:// dx.doi.org/10.1111/j.1365-2796.2007.01809.x

Johnson MJ, Wootton SA, Leaf AA, Jackson AA. Preterm birth and body composition at term equivalent age: A systematic review and meta analysis. Pediatrics. 2012; 130(3):e640-9. http:// dx.doi.org/10.1542/peds.2011-3379

Ballard JL, Khoury JC, Wedig K, Wang L, Eilers Walsman BL, Lipp R. New Ballard score, expanded to include extremely premature infants. J Pediatr. 1991; 119(3):417-23.

Rodríguez G, Ventura P, Samper MP, Moreno L, Sarría A, Pérez-González JM. Changes in body composition during the initial hours of life in breast fed healthy term newborns. Biol Neonate. 2000; 77(1):12-6.

Villela LV. O crescimento e a composição corporal dos recém-nascidos prematuros de muito baixo peso ao nascer [dissertação]. Rio de Janeiro: Fiocruz; 2007.

Méio MD, Sichieri R, Soares FV, Moreira ME. Total body water in small- and appropriate- for gestational age newborns. J Perinat Med. 2008; 36(4):354-8. http//:dx.doi.org/10.1515/JPM.2008. 058

Tang W, Ridout D, Modi N. Assessment of total body water using bioelectrical impedance analysis in neonates receiving intensive care. Arch Dis Child Fetal Neonatal. 1997; 77(2):123-6. http://dx.doi. org/10.1136/fn.77.2.F123

Moreira MEL. Avaliação do crescimento e composição corporal de recém-nascidos pré-termo [doutorado]. São Paulo: Universidade de São Paulo; 1997.

Sasanow SR, Georgieff MK, Pereira GR. Mid-arm circumference and mid-arm/head circumference ratios: Standard curves for anthropometric assessment of neonatal nutritional status. J Pediatr. 1986; 109(2):311-5.

Sociedade Brasileira de Pediatria, Departamento Científico de Nutrologia. Avaliação nutricional da criança e do adolescente: manual de orientação. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2009.

Catalano PM, Drago NM, Amini SB. Factors affecting fetal growth and body composition. Am J Obstet Gynecol. 1995; 172(5):1459-63. http:// dx.doi.org/10.1016/0002-9378(95)90478-6

Fenton TR, Kim JH. A systematic review and meta analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics. 2013; 13:59. http:// dx.doi.org/10.1186/1471-2431-13-59

Cooke RJ, Griffin I. Altered body composition in preterm infants at hospital discharge. Acta Paediatr. 2009; 98(8):1269-73. http://dx.doi.org/10.1111/j. 1651-2227.2009.01354.x

Costa-Orvay JA, Figueras-Aloy J, Romera G, Closa Monasterolo R, Carbonell-Estrany X. The effects of varing protein and energy intakes on the growth and body composition of very low birth weight infants. Nutr J. 2011; 10:140. http://dx.doi.org/ 10.1186/1475-2891-10-140

Cheong JLY, Hunt RW, Anderson PJ, Howard K, Thompson DK, Wang HX, et al. Head growth in preterm infants: Correlation with magnetic resonance imaging and neurodevelopmental outcome. Pediatrics. 2008; 121(6):e1534-40. http:// dx.doi.org/10.1542/peds.2007-2671

Roggero P, Giannì ML, Amato O, Orsi A, Piemontese P, Morlacchi L, et al. Is term newborn body composition being achieved postnatally in preterm infants? Early Hum Dev. 2009; 85(6):349-52. http:// dx.doi.org/10.1016/j.earlhumdev.2008.12.011

Okada T, Takahashi S, Nagano N, Yoshikawa K, Usukura Y, Hosono S. Early postnatal alteration of body composition in preterm and small-for-gestational-age infants: Implications of catch-up fat. Pediatr Res. 2015; 77(1-2):136-42. http://dx. doi.org/10.1038/pr.2014.164

Gianini NM, Vieira AA, Moreira MEL. Avaliação dos fatores associados ao estado nutricional na idade corrigida de termo em recém-nascidos de muito baixo peso. J Pediatr. 2005; 81(1):34-40.

Lima PA, Carvalho M, Costa AC, Moreira ME. Variables associated with extra uterine growth restriction in very low birth weight infants. J Pediatr. 2014; 90(1):22-7. http://dx.doi.org/10.1016/j.jped. 2013.05.007

Lima PA, de Carvalho M, da Costa AC, Moreira ME. Author’s reply: Z-Score: Fenton 2013. Ten-year update. J Pediatr. 2014; 90(4):427-8. http://dx.doi. org/10.1016/j.jped.2014.04.004

Embleton NE, Pang N, Cooke RJ. Postnatal malnutrition and growth retardation: An inevitable consequense of current recommendations in preterm infants? Pediatrics. 2001; 107(2):270-3. http://dx.doi.org/10.1542/peds.107.2.270

Daly-Wolfe K, Jordan K, Slater H, Beachy J, Moyer Mileur L. Mid-arm circumference is a reliable predictor of adiposity in preterm and term infants. Pediatr Res. 2015; 78(3):336-41. http://dx.doi.org/ 10.1038/pr.2015.103.

Rice MS, Valentine CJ. Neonatal body composition: Measuring lean mass as a tool to guide nutrition management in the neonate. Nutr Clin Pract. 2015;30(5):625-32. http://dx.doi.org/10.1177/08 84533615578917

Cooke R. Nutrition of preterm infants after discharge. Ann Nutr Metab. 2011; 58(Suppl. 1):32-6. http:// dx.doi.org/10.1159/000323385 41. Roggero P, Giannì ML, Liotto N, Taroni F, Orsi A, Amato O, et al. Rapid recovery of fat mass in small for gestational age preterm infants after term. PLoS ONE. 2011; 6(1):e14489. http://dx.doi.org/10.13 71/journal.pone.0014489

Giannì ML, Roggero P, Piemontese P, Orsi A, Amato O, Taroni F, et al. Body composition in newborn infants: 5-year experience in an Italian neonatal intensive care unit. Early Hum Dev. 2012; 88(Suppl. 1):13-7. http://dx.doi.org/10.1016/j.earlhumdev. 2011.12.022

Menezes CFB, Neves J, Gonsalez PS, Vasconcelos FAG. Incidência de sobrepeso/obesidade em pré- -escolares durante dois anos de acompanhamento. Rev Nutr. 2014; 27(3):269-78. http://dx.doi.org/ 10.1590/1415-52732014000300001

Olsen IE, Lawson ML, Ferguson AN, Cantrell R, Grabich SC, Zemel BS, et al. BMI curves for preterm infants. Pediatrics. 2015; 135(3):e572-81. http:// dx.doi.org/10.1542/peds.2014-2777

Niklasson A1, Albertsson-Wikland K. Continuous growth reference from 24th week of gestation to 24 months by gender. BMC Pediatr. 2008; 8:8. http://dx.doi.org/10.1186/1471-2431-8-8

Published

2023-04-05

How to Cite

Duarte VILLELA, L. ., Valente MENDES SOARES, F. ., Dunshee de ABRANCHES, A. ., GOMES JUNIOR, S.-C., Barbosa Baker MÉIO, M. D. ., & Lopes MOREIRA, M. E. (2023). Anthropometry and body composition of preemies at term age and term age weight. Brazilian Journal of Nutrition, 28(6). Retrieved from https://seer.sis.puc-campinas.edu.br/nutricao/article/view/8259

Issue

Section

ORIGINAL ARTICLE