KU Leuven, Leuven, Belgium.
Department of Development and Regeneration, and Department of Pharmaceutical and Pharmacological Sciences Organ Systems, KU Leuven, Leuven, Belgium.
Eur J Pediatr. 2020 May;179(5):757-771. doi: 10.1007/s00431-019-03552-z. Epub 2020 Jan 4.
Preterm infants are obviously born lighter and shorter, with smaller head circumferences than normal birth weight term born neonates. They also have a different body composition. Compromised growth is associated with adverse health outcomes. Both growth retardation and accelerated growth are suggested to cause metabolic, cardiovascular, and renal complications. Reviews regarding growth and body composition in preterm infants often do not differentiate between birth weight and gestational age. The purpose of this systematic review is to assemble growth data, specific in extremely low birth weight children. Different databases were searched for studies regarding growth and body composition in former extremely low birth weight infants until adulthood. We compared height, weight, head circumference, body mass index, fat mass, lean mass, fat distribution, and body water to matched normal birth weight controls and the World Health Organization growth charts. Studies consistently reported that former extremely low birth weight neonates experience a period of accelerated postnatal growth, but they achieve lower anthropometric parameters than normal birth weight children. There is no consensus about differences in body composition and how to measure this.Conclusion: Although extremely low birth weight infants exhibit a period of catch-up growth, their growth remains retarded later in life. Further research is needed to investigate body composition and the associated risk of cardiovascular diseases or metabolic syndrome.What is Known:• Extremely low birth weight infants have lower anthropometric parameters and a different body composition at birth and term-corrected age than normal birth weight infants.• Former extremely low birth weight infants also have a higher risk on adverse cardiovascular health outcomes in later life.What is New:• After hospital discharge, extremely low birth weight neonates remain smaller and probably also lighter, with smaller head circumferences at each corrected age throughout childhood and adolescence when compared to normal birth weight infants or the World Health Organization growth charts. It is not clear whether extremely low birth weight infants reach a lower or similar body mass index score as normal birth weight infants.• There is a lack of (long-term) information on body composition in extremely low birth weight infants.
早产儿的出生体重和身长明显低于正常足月儿,头围也较小。他们的身体成分也不同。生长受限与不良健康结局相关。生长迟缓或加速生长都可能导致代谢、心血管和肾脏并发症。关于早产儿生长和身体成分的综述通常没有区分出生体重和胎龄。本系统综述的目的是收集极低出生体重儿生长数据。检索了多个数据库,以获取关于以前极低出生体重儿直至成年期的生长和身体成分的研究。我们将身高、体重、头围、体重指数、体脂量、去脂体重、体脂分布和体水分与匹配的正常出生体重对照组和世界卫生组织生长曲线进行了比较。研究一致表明,以前极低出生体重儿经历了一段加速的出生后生长,但他们的体格参数比正常出生体重儿低。关于身体成分的差异以及如何测量,尚无共识。
尽管极低出生体重儿有追赶生长期,但他们的生长在以后的生活中仍会受到限制。需要进一步研究身体成分以及与心血管疾病或代谢综合征相关的风险。
极低出生体重儿出生时和胎龄校正时的体格参数和身体成分与正常出生体重儿不同。
以前极低出生体重儿在以后的生活中也有更高的心血管健康不良结局风险。
出院后,极低出生体重儿在每个校正年龄时仍较小,与正常出生体重儿或世界卫生组织生长曲线相比,在儿童期和青春期时,头围也较小。尚不清楚极低出生体重儿是否达到与正常出生体重儿相似或较低的体重指数评分。
极低出生体重儿的身体成分缺乏(长期)信息。