Determinants of body composition in preterm infants at the time of hospital discharge

Simon, Laure; Frondas-Chauty, Anne; Senterre, Thibault; Flamant, Cyrille; Darmaun, Dominique; Rozé, Jean‐Christophe

doi:10.3945/ajcn.113.080945

Cited by 61 publications

(89 citation statements)

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“…Yet neonatal weight gain alone is unlikely to reflect the quality of growth. Despite adequate neonatal weight gain, preterm infants may have an altered body composition, with a higher fat mass at discharge, compared with term infants [6, 7]. Body composition can be measured using air-displacement plethysmography, but requires equipment (such as the PEA POD® Infant Body Composition System; COSMED, Concord, CA, USA).…”

Section: Introductionmentioning

confidence: 99%

In Preterm Infants, Length Growth below Expected Growth during Hospital Stay Predicts Poor Neurodevelopment at 2 Years

et al. 2018

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Background: In preterm infants, neonatal weight growth is associated with neurodevelopmental outcome but is a poor indicator of growth quality. Objective: The aim of this work was to measure the relationship between neonatal length growth and the 2-year neurological outcome in preterm infants. Methods: A total of 2,403 infants enrolled in the LIFT cohort with gestational age less than 34 weeks were studied. Neonatal observed length growth (OLG) was calculated as the change in length Z-score between birth and discharge. Expected length growth (ELG) was estimated based on gestational age, birth weight Z-score, birth length Z-score, gender, and observed neonatal weight growth. The difference between OLG and ELG (∆_OLG-ELG) was calculated as OLG – ELG, and infants were ranked into 3 classes depending on their ∆_OLG-ELG (≤–0.5, –0.49 to 0.49, ≥0.50 Z-score). We explored the relationship between ∆_OLG-ELG and 2-year neurodevelopmental outcome (n = 2,036), and, in a subgroup (n = 85), between ∆_OLG-ELG and body composition at discharge. Results: ELG was strongly predicted from the above-mentioned parameters (R² = 0.73, p = 0.001). OLG correlated closely with gestational age (p = 0.001) but ∆_OLG-ELG did not (p = 1.0). OLG was not associated with a 2-year nonoptimal outcome after adjustment for gestational age, but ∆_OLG-ELG ≤–0.5 was; the crude and adjusted odds ratios were 1.63 and 1.56, respectively. ∆_OLG-ELG correlated negatively with fat mass (R² = 0.29, p = 0.006) before and after adjustment for gestational age. Conclusion: ∆_OLG-ELG is a marker of neonatal growth that does not depend on gestational age, and may reflect quality of growth. A ∆_OLG-ELG ≤–0.5 Z-score is associated with a higher risk for 2-year nonoptimal neurodevelopmental outcome.

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Section: Introductionmentioning

confidence: 99%

In Preterm Infants, Length Growth below Expected Growth during Hospital Stay Predicts Poor Neurodevelopment at 2 Years

et al. 2018

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“…Мониторинг нутритивного статуса детей первого года жизни, родившихся недоношенными, позволяет выявить его отклонения по мере роста и развития ребенка [10]. В ряде исследований показано, что недоношенные дети, родившиеся с низкой массой тела (НМТ), в первые меся-цы жизни имеют более высокую долю жировой массы тела по сравнению с доношенными детьми [11][12][13], что может привести в дальнейшем к нарушению толерант-ности к глюкозе и развитию метаболического синдрома [14]. Вместе с тем имеется недостаточно научных данных о составе массы тела детей, родившихся с экстремаль-но низкой и очень низкой массой тела (ЭНМТ/ОНМТ), и его влиянии на физическое и психомоторное разви-тие.…”

Section: обоснованиеunclassified

Nutritional Status, Physical and Psychomotor Development of Premature Infants: A Prospective Observational Comparative Study

Турти¹,

Горбачёва²,

Лукоянова³

2018

Pediatr. farmakol.

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Развитие недоношенных детей происходит медленнее, чем у детей, родившихся в срок, часто по причине откло-нений в нутритивном статусе недоношенных. Цель исследования -изучить состояние нутритивного статуса, физического и психомоторного развития детей первого года жизни. Методы. Нутритивный статус -состав (соот-ношение жировых и безжировых тканей) и значение безжировой массы тела (БЖМТ) -оценивали методами пле-тизмографии и денситометрии; физическое развитие -путем измерения массы и длины тела, окружности головы и груди, расчета индекса массы тела (ИМТ); психомоторное развитие -оценивая соответствие графику нервно-психического развития младенцев (ГНОМ ЭНМТ -3397 (3096; 3608) и ОНМТ -3824 (3797; 3899) была ниже, чем у детей с НМТ -4497 (4034; 4651) и доношенных -4511 (3887; 4647) (тест Краскела-Уоллиса, р=0,048 Под нутритивным статусом мы понимаем состоя-ние организма, его структуры (соотношение мышеч-ной и жировой массы тела) и функций, сложившееся под влиянием количественных и качественных осо-бенностей фактического питания. Особенно актуальной эта проблема является для детей, родившихся недоно-шенными, с тяжелой перинатальной патологией [4,5]. Именно эта категория пациентов может быть на протя-жении длительного периода времени ограничена в полу-чении и усвоении энтерального питания с развитием белково-энергетической недостаточности, что приводит к необходимости продолжительного этапного выхажи-вания [6,7]. Имеются данные, что несбалансированное 51Background. The development of premature infants is slower than that of term ones, often due to nutritional status disorders in preterm infants. Objective. Our aim was to study the nutritional status, physical, and psychomotor development of infants. Methods. 12-14 and 16-18 397 (3,096;3,608) and with 824 (3,797;3,899) was lower than in infants with 497 (4,034;4,511 (3,887;4,647) p = 0.048 Nutritional status -the composition (the ratio of fat and fat-free tissues) and the value of lean body mass (LBM) -was assessed by plethysmography and densitometry; physical development -by measuring the mass and length of the body, the circumference of the head and chest, calculating the body mass index (BMI); psychomotor development -assessing compliance with the schedule of neuropsychological development of infants (GNOM). The examination was carried out at

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“…O crescimento pós-natal de Recém-Nascidos Pré-Termo (RNPT) deve ser semelhante ao que ocorre intraútero, tanto na velocidade de crescimento como na composição corporal [4][5][6] . Apesar dessa recomendação, a restrição do crescimento pós-natal é uma realidade mundial, e estudos atuais sugerem uma nutrição precoce e agressiva do ponto de vista proteico-calórico como tentativa de evitá-la [7][8][9][10][11] . Entretanto, existe a preocupação com o crescimento acelerado no período pós-natal, que pode estar associado com o desenvolvimento da síndrome metabólica e doença cardiovascular na vida adulta [12][13][14][15][16] .…”

Section: N T R O D U ç ã Ounclassified

“…Embleton et al 37 demonstraram que a restrição do crescimento pós-natal está relacionada com a deficiência cumulativa da ingestão proteica e calórica observada até a quinta semana de vida. Simon et al 10 evidenciaram uma associação entre a baixa idade gestacional e a diminuição do escore-Z do peso durante a internação com um maior risco de déficit de massa livre de gordura. Apesar de as avaliações terem sido realizadas em momentos diferentes (alta hospitalar no estudo de Simon et al 10 e na idade gestacional corrigida de termo no nosso estudo), os resultados foram semelhantes, assim como os resultados do estudo de Daly-Wolfe et al 38 .…”

Section: I S C U S S ã Ounclassified

Antropometria e composição corporal de recém-nascidos pré-termo na idade gestacional e no peso equivalente ao termo

et al. 2015

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Antropometria e composição corporal de recém-nascidos pré-termo na idade gestacional e no peso equivalente ao termo Anthropometry and body composition of preemies at term age and term age weight R E S U M O ObjetivoAnalisar o crescimento e a composição corporal de recém-nascidos pré-termo na idade gestacional corrigida de termo e ao alcançarem um peso entre 3,0 e 3,5 kg. MétodosEstudo longitudinal, realizado no Instituto Fernandes Figueira, Rio de Janeiro, com 39 recém-nascidos pré-termo e que apresentaram muito baixo peso ao nascer. Medidas antropométricas e água corporal total foram avaliadas no primeiro, no sétimo e no dia da recuperação do peso de nascimento, na idade gestacional corrigida do termo e em torno de três semanas de idade gestacional corrigida (correspondente ao tempo de vida para alcançar um peso entre 3,0 e 3,5 kg). O grupo de referência foi constituído por 32 recém-nascidos a termo, adequados para a idade gestacional, avaliados no segundo dia de vida. Considerou-se restrição de crescimento o escore-Z menor do que -2 para peso, comprimento e perímetro cefálico. ResultadosNa idade de termo, 71,8% dos recém-nascidos pré-termo apresentaram restrição do crescimento para peso, 61,5% para comprimento e 25,6% para perímetro cefálico. Com três semanas de idade gestacional corrigida, esses recém-nascidos apresentaram a prega cutânea tricipital e a circunferência abdominal estatisticamente maiores que o grupo de referência enquanto o comprimento e a porcentagem de água corporal total foram menores. ConclusãoOs recém-nascidos pré-termo apresentaram perfil antropométrico e de água corporal diferente dos recém--nascidos a termo, sugerindo acúmulo de gordura. Houve recuperação do crescimento entre a idade de termo e três semanas de idade corrigida, sendo mais evidente esse crescimento em relação ao perímetro cefálico e peso.Palavras-chave: Antropometria. Composição corporal. Prematuro. Recém-nascido. A B S T R A C T ObjectiveTo 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 ConclusionThe 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.

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Determinants of body composition in preterm infants at the time of hospital discharge

Abstract: The initial growth and quality of nutrition were significantly associated with absolute FFM accretion during a hospital stay in preterm infants. This trial was registered at clinicaltrials.gov as NCT01450436.

Cited by 61 publications

References 29 publications

In Preterm Infants, Length Growth below Expected Growth during Hospital Stay Predicts Poor Neurodevelopment at 2 Years

In Preterm Infants, Length Growth below Expected Growth during Hospital Stay Predicts Poor Neurodevelopment at 2 Years

Nutritional Status, Physical and Psychomotor Development of Premature Infants: A Prospective Observational Comparative Study

Antropometria e composição corporal de recém-nascidos pré-termo na idade gestacional e no peso equivalente ao termo

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