Nel Sanja, Feucht Ute D, Mulol Helen, Wenhold Friede Am
Department of Human Nutrition, University of Pretoria, Pretoria, South Africa; Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa.
Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa; Department of Paediatrics, University of Pretoria, Pretoria, South Africa; Gauteng Department of Health, Tshwane District Health Services, Pretoria, South Africa.
J Nutr. 2023 Apr;153(4):958-969. doi: 10.1016/j.tjnut.2023.02.007. Epub 2023 Feb 10.
Placental insufficiency negatively impacts fetal growth and body composition (BC), potentially affecting lifelong health. Placental insufficiency, detectable as an abnormal umbilical artery resistance index (UmA-RI) on Doppler ultrasonography, is highly prevalent in otherwise healthy South African pregnant women. Appropriate intervention reduces stillbirth and perinatal death, but research on long-term outcomes of surviving infants is lacking.
This study aimed to describe and compare anthropometry and BC during the first 2 y of life in a cohort of term-born infants with normal and abnormal prenatal UmA-RI.
Term-born infants (n = 81; n = 55 normal, n = 26 abnormal UmA-RI on third trimester Doppler screening) were followed up at 8-time points until age 2 y. Anthropometric measurements were taken, and FFM and FM were assessed by deuterium dilution. Age- and sex-specific z-scores were calculated for anthropometric indices, FM, FFM, FM index (FMI), and FFM index (FFMI) using appropriate reference data. Anthropometry and BC of infants with normal and abnormal UmA-RI were compared using an independent t-test or Mann-Whitney test.
At most ages, group mean z-scores were <0 for length-for-age and FM and >0 for weight-for-length and FFM. Compared with infants with normal UmA-RI, infants with abnormal UmA-RI had significantly lower weight-for-age z-scores at birth (-0.77 ± 0.75 compared with -0.30 ± 1.10, P = 0.026), ages 10 wk to 9 mo (-0.4 ± 0.87 to -0.2 ± 1.12 compared with 0.3 ± 0.85 to 0.6 ± 1.09; P = 0.007-0.017) and 18 mo (-0.6 ± 0.82 compared with 0.1 ± 1.18; P = 0.037); length-for-age z-scores at ages ≤14 wk (-1.3 ± 1.25 to -0.9 ± 0.87 compared with -0.2 ± 1.04 to -0.1 ± 1.00; P = 0.004-0.021); and FFM-for-age z-scores at ages ≤9 mo (-0.1 ± 0.82 to 0.7 ± 0.71 compared with 0.7 ± 1.00 to 1.3 ± 0.85; P = 0.002-0.028). FFMI, percentage FFM, FM, percentage FM, and FMI showed no consistent significant differences.
Infants with abnormal UmA-RI had lower weight-for-age and length-for-age z-scores, particularly at younger ages, with proportionally lower FFM but no consistent differences in percentage FFM and FFMI. These findings merit further investigation in larger cohorts.
胎盘功能不全对胎儿生长和身体成分（BC）产生负面影响，可能会影响终身健康。胎盘功能不全在超声多普勒检查中表现为脐动脉阻力指数（UmA-RI）异常，在其他方面健康的南非孕妇中非常普遍。适当的干预可降低死产和围产期死亡，但缺乏对存活婴儿长期结局的研究。
本研究旨在描述和比较足月出生的产前UmA-RI正常和异常的婴儿队列在出生后2年内的人体测量学和身体成分。
对足月出生的婴儿（n = 81；n = 55正常，n = 26在孕晚期多普勒筛查中UmA-RI异常）进行8个时间点的随访，直至2岁。进行人体测量，并通过氘稀释法评估去脂体重（FFM）和脂肪量（FM）。使用适当的参考数据计算人体测量指数、FM、FFM、脂肪量指数（FMI）和去脂体重指数（FFMI）的年龄和性别特异性z评分。使用独立t检验或曼-惠特尼检验比较UmA-RI正常和异常婴儿的人体测量学和身体成分。
在大多数年龄段，年龄别身长和FM的组平均z评分<0，身长别体重和FFM的组平均z评分>0。与UmA-RI正常的婴儿相比，UmA-RI异常的婴儿在出生时年龄别体重z评分显著更低（-0.77±0.75对比-0.30±1.10，P = 0.026），在10周龄至9月龄时（-0.4±0.87至-0.2±1.12对比0.3±0.85至0.6±1.09；P = 0.007 - 0.
