Birth Size as a Determinant of Cardiometabolic Risk Factors in Children

Abstract

The association between birth size and cardiometabolic disease risk may be U-shaped. Being born small for gestational age (SGA) has a definitive association with later cardiovascular risk, but the impact of being born large for gestational age (LGA) on cardiometabolic health is more controversial. In addition to birth size, early postnatal growth pattern and later weight gain affect cardiometabolic risk in adulthood. Most SGA-born children have catch-up and LGA-born children have catch-down growth during the first years of life. The extent of this early compensatory growth may contribute to the adverse health outcomes. Both SGA-and LGAborn children are at an increased risk for overweight and obesity. This may have a long-term impact on cardiometabolic health as overweight tends to track to adulthood. Other cardiometabolic risk factors, including alterations in glucose metabolism, dyslipidemia, hypertension, and lowgrade inflammation are associated with birth weight. Many of these risk factors are related to overweight or adverse fat distribution. Since later cardiometabolic risk is often mediated by early growth pattern and later overweight in SGA and LGA children, it is important to focus on staying normal weight throughout life. Hence, effective interventions to reduce cardiometabolic risk in LGA and SGA children should be developed.

Prenatal Exposure to Favorable Social and Environmental Neighborhood Conditions Is Associated with Healthy Pregnancy and Infant Outcomes

“…Gestation is a critical period of development, when risk and protective exposures can influence health across the life course [ 1 , 2 ]. Birth size outcomes, including birth weight, length, head circumference, and intrauterine growth restriction, have been commonly examined as indicators of the quality of the intrauterine environment [ 1 ], and may also be sentinels for future health risk [ 3 , 4 ]. Moreover, patterning in prenatal exposure and birth size associations are often sex-specific [ 5 ], with male and female developing body systems differentially affected by social and environmental exposures [ 6 ].…”

Bone Mineral Density, Body Composition, and Metabolic Health of Very Low Birth Weight Infants Fed in Hospital Following Current Macronutrient Recommendations during the First 3 Years of Life

“…The greatest variation in rates of weight gain is seen in the first two years of life when infants may show significant "catch-up" or "catchdown" growth. At the opposite extreme, the effect of high birth weight on later insulin resistance and cardiovascular disease is less clear [18]. These studies suggest that there may be an optimal range for healthy growth.…”

“…Low birth weight (LBW) is associated with an increased risk of insulin resistance, truncal accumulation of fat, metabolic syndrome, and cardiovascular disease in adulthood [17,18]. Likewise, in preterm infants, weight gain before discharge and during the first 3 months post-discharge weight gain have been related to later metabolic disease or obesity [19,20].…”

Prenatal Maternal Docosahexaenoic Acid (DHA) Supplementation and Newborn Anthropometry in India: Findings from DHANI

“…LBW and preterm birth are leading causes of neonatal death in LMICs [3]. In addition, LBW is associated with an increased risk of numerous adverse health outcomes in childhood [4,5] and adulthood [6,7]. Women in deprived socio-economic conditions frequently have poor nutrition and consequently deliver infants with LBW [8].…”