Bortolotto Caroline Cardozo, Santos Iná S, Dos Santos Vaz Juliana, Matijasevich Alicia, Barros Aluísio J D, Barros Fernando C, Santos Leonardo Pozza, Munhoz Tiago Neuenfeld
Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.
Pontifical Catholic University of Rio Grande do Sul, Program of Pediatrics and Child Health, Porto Alegre, Brazil.
BMC Public Health. 2021 Feb 9;21(1):321. doi: 10.1186/s12889-021-10368-w.
We aimed to investigate the association between preterm birth and body composition at 6, 18, and 30 years of age using data from three population-based birth cohort studies.
Gestational age (GA), defined by the date of the last menstrual period (categorized in ≤33, 34-36, and ≥ 37 weeks), was gathered in the first 24-h after delivery for all live births occurring in the city of Pelotas, Brazil, in 2004, 1993 and 1982. Body composition was assessed by air-displacement plethysmography. Outcomes included fat mass (FM, kg), percent FM (%FM), FM index (FMI, kg/m), fat-free mass (FFM, kg); percent FFM (%FFM), FFM index (FFMI, kg/m), body mass index (BMI, kg/m at 18 years in the 1993 cohort and 30 years in the 1982 cohort), and BMI Z-score (at 6 years in the 2004 cohort). We further explored the association of birth weight for GA with body composition indicators and BMI. Crude and adjusted linear regressions provided beta coefficients with 95% confidence intervals (95%CI).
A total of 3036, 3027, and 3369 participants, respectively, from the 2004, 1993, and 1982 cohorts were analyzed. At 6 years, preterm boys (born at 34-36 weeks) presented lower adjusted mean of FM (β = - 0.80 kg, - 1.45;-0.16, p = 0.046), %FM (β = - 2.39%, - 3.90;-0.88, p = 0.008), FMI (β = - 0.70 kg/m, - 1.13;-0.27, p = 0.004) as well as lower FFM (β = - 0.4 kg, - 0.77; - 0.12, p = 0.010) and FFMI (β = - 0.3 kg/m, - 0.46;-0.10, p < 0.001), and BMI Z-score (β = - 0.69,; - 0.99;-0.40, p < 0.001); but higher %FFM (β = 2.4%, 0.87;-3.90, p = 0.008), when compared to boys born at term (≥37). At 30 years, FM (15.7 kg, 0.25;31.1, p = 0.102) was higher among males born at ≤33 weeks. No association was observed for females from the three cohorts and for 18-year-old males. The association of birth weight for GA with body composition and BMI was not significant in any cohort. At 6 years, SGA boys had lower FFMI than boys AGA.
Our results suggest that preterm birth is associated with decreased body fat and fat-free mass in childhood but higher fat mass in adulthood. Nevertheless, results were only significant for males. SGA boys also showed lower FFMI.
我们旨在利用三项基于人群的出生队列研究数据，调查早产与6岁、18岁和30岁时身体成分之间的关联。
收集了巴西佩洛塔斯市2004年、1993年和1982年所有活产婴儿出生后24小时内的末次月经日期所定义的孕周（分为≤33周、34 - 36周和≥37周）。通过空气置换体积描记法评估身体成分。结局指标包括脂肪量（FM，kg）、脂肪量百分比（%FM）、脂肪量指数（FMI，kg/m）、去脂体重（FFM，kg）；去脂体重百分比（%FFM）、去脂体重指数（FFMI，kg/m）、体重指数（BMI，1993年队列中18岁时以及1982年队列中30岁时的kg/m）和BMI Z评分（2004年队列中6岁时）。我们进一步探讨了孕周别出生体重与身体成分指标和BMI之间的关联。粗线性回归和调整线性回归提供了带有95%置信区间（95%CI）的β系数。
分别对来自2004年、1993年和1982年队列的3036名、3027名和3369名参与者进行了分析。6岁时，早产男孩（34 - 36周出生）的FM调整后均值较低（β = - 0.80 kg，- 1.45；-0.16，p = 0.046）、%FM较低（β = - 2.39%，- 3.90；-0.88，p = 0.008）、FMI较低（β = - 0.70 kg/m，- 1.13；-0.27，p = 0.004），以及FFM较低（β = - 0.4 kg，- 0.77； - 0.12，p = 0.010）和FFMI较低（β = - 0.3 kg/m，- 0.46；-0.10，p < 0.001），BMI Z评分较低（β = - 0.69，； - 0.99；-0.40，p < 0.001）；但与足月儿（≥37周）相比，%FFM较高（β = 2.4%，0.87；-3.90，p = 0.008）。30岁时，≤33周出生的男性FM较高（15.7 kg，0.25；31.1，p = 0.102）。在三个队列中的女性以及18岁男性中未观察到关联。在任何队列中，孕周别出生体重与身体成分和BMI之间的关联均不显著。6岁时，小于胎龄儿男孩的FFMI低于适于胎龄儿男孩。
我们的结果表明，早产与儿童期身体脂肪和去脂体重减少有关，但与成年期较高的脂肪量有关。然而，结果仅在男性中显著。小于胎龄儿男孩的FFMI也较低。
