Department of Neonatology, CHU Nantes, Nantes, France
INRAE, UMR 1280, Physiologie des Adaptations Nutritionnelles, Nantes University, Nantes, France.
Arch Dis Child Fetal Neonatal Ed. 2023 Mar;108(2):149-155. doi: 10.1136/archdischild-2022-324321. Epub 2022 Aug 25.
To identify the characteristics of early life growth associated with later overweight or obesity (OWO) in very preterm population.
Length, weight and body mass index (BMI) were prospectively recorded from three prospective, population-based cohorts with 5 years (Loire Infant Follow-up Team (LIFT), EPIPAGE2 (Etude EPIdémiologique sur les Petits Ages GEstationnels 2)) and 15 years (EPIPAGEADO, Etude EPIdémiologique sur les Petits Ages GEstationnels-Adolescents) of follow-up. Missing data were imputed.
Regional (LIFT), national (EPIPAGE2) and multiregional (EPIPAGEADO) cohorts in France.
Eligible infants born before 33 weeks of gestation in 1997 (EPIPAGEADO), between 2003 and 2014 (LIFT), and in 2011 (EPIPAGE2).
OWO was determined as BMI Z-score >85th percentile of the WHO reference curves at 5 years (LIFT, EPIPAGE2) and 15 years (EPIPAGEADO).
In EPIPAGEADO, LIFT and EPIPAGE2, BMI Z-scores were known for 302 adolescents, 1016 children and 2022 children, respectively. In EPIPAGEADO, OWO was observed in 42 (13.9%, 95% CI 10.5 to 18.3) adolescents. In multivariable models, birthweight Z-score, increase in weight Z-score during neonatal hospital stay and increase in BMI between discharge and at 2 years of corrected age were positively associated with OWO at 15 years (adjusted OR (aOR)=3.65, 95% CI 1.36 to 9.76; aOR=3.82, 95% CI 1.42 to 10.3; and aOR=2.55, 95% CI 1.72 to 3.78, respectively, by Z-score), but change in length Z-score during neonatal hospital stay was negatively associated (aOR=0.41, 95% CI 0.21 to 0.78, p=0.007). These four associations with OWO assessed at 5 years were confirmed in the LIFT and EPIPAGE2 cohorts.
Change in length Z-score during hospitalisation, a putative proxy of quality of neonatal growth, was negatively associated with risk of later OWO when change in BMI between discharge and at 2 years was included in the multivariable model.
确定与极低出生体重儿（VLBW）后期超重或肥胖（OWO）相关的早期生长特征。
前瞻性记录了来自三个前瞻性、基于人群的队列的 5 年（Loire Infant Follow-up Team（LIFT）、EPIPAGE2（Etude EPIdémiologique sur les Petits Ages GEstationnels 2））和 15 年（EPIPAGEADO，Etude EPIdémiologique sur les Petits Ages GEstationnels-Adolescents）的随访中的身长、体重和体重指数（BMI）。缺失数据采用插补法处理。
法国的区域（LIFT）、国家（EPIPAGE2）和多区域（EPIPAGEADO）队列。
1997 年出生于妊娠 33 周前的婴儿（EPIPAGEADO）、2003 年至 2014 年（LIFT）和 2011 年（EPIPAGE2）。
OWO 定义为 5 岁（LIFT、EPIPAGE2）和 15 岁（EPIPAGEADO）时 WHO 参考曲线 BMI Z 评分>85 百分位。
在 EPIPAGEADO、LIFT 和 EPIPAGE2 中，分别有 302 名青少年、1016 名儿童和 2022 名儿童的 BMI Z 评分已知。在 EPIPAGEADO 中，有 42 名（13.9%，95%CI 10.5%至 18.3%）青少年患有 OWO。在多变量模型中，出生体重 Z 评分、新生儿住院期间体重 Z 评分增加以及出院至 2 岁时 BMI 增加与 15 岁时的 OWO 呈正相关（调整后的比值比[aOR]=3.65，95%CI 1.36 至 9.76；aOR=3.82，95%CI 1.42 至 10.3；aOR=2.55，95%CI 1.72 至 3.78，Z 评分），但新生儿住院期间身长 Z 评分的变化呈负相关（aOR=0.41，95%CI 0.21 至 0.78，p=0.007）。在 LIFT 和 EPIPAGE2 队列中也证实了与 5 岁时 OWO 相关的这四个关联。
当将出院至 2 岁时 BMI 之间的变化纳入多变量模型时，住院期间身长 Z 评分的变化（新生儿生长质量的替代指标）与后期 OWO 的风险呈负相关。
