Elmrayed Seham, Pinto Jahaira, Tough Suzanne C, McDonald Sheila W, Scime Natalie V, Wollny Krista, Lee Yoonshin, Kramer Michael S, Ospina Maria B, Lorenzetti Diane L, Madubueze Ada, Leung Alexander A, Kumar Manoj, Fenton Tanis R
Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Paediatr Perinat Epidemiol. 2023 Sep;37(7):652-668. doi: 10.1111/ppe.13002. Epub 2023 Aug 14.
Overweight and obesity and their consequent morbidities are important worldwide health problems. Some research suggests excess adiposity origins may begin in fetal life, but unknown is whether this applies to infants born preterm.
The objective of the study was to assess the association between small for gestational age (SGA) birth and later adiposity and height among those born preterm.
MEDLINE, EMBASE and CINAHL until October 2022.
Studies were included if they reported anthropometric (adiposity measures and height) outcomes for participants born preterm with SGA versus non-SGA. Screening, data extraction and risks of bias assessments were conducted in duplicate by two reviewers.
We meta-analysed across studies using random-effects models and explored potential heterogeneity sources.
Thirty-nine studies met the inclusion criteria. In later life, preterm SGA infants had a lower body mass index (-0.66 kg/m , 95% CI -0.79, -0.53; 32 studies, I = 16.7, n = 30,346), waist circumference (-1.20 cm, 95% CI -2.17, -0.23; 13 studies, I = 19.4, n = 2061), lean mass (-2.62 kg, 95% CI -3.45, 1.80; 7 studies, I = 0, n = 205) and height (-3.85 cm, 95% CI -4.73, -2.96; 26 studies, I = 52.6, n = 4174) compared with those preterm infants born non-SGA. There were no differences between preterm SGA and preterm non-SGA groups in waist/hip ratio, body fat, body fat per cent, truncal fat per cent, fat mass index or lean mass index, although power was limited for some analyses. Studies were rated at high risk of bias due to potential residual confounding and low risk of bias in other domains.
Compared to their preterm non-SGA peers, preterm infants born SGA have lower BMI, waist circumference, lean body mass and height in later life. No differences in adiposity were observed between SGA preterm infants and non-SGA preterm infants.
超重和肥胖及其引发的疾病是全球重要的健康问题。一些研究表明，肥胖的根源可能始于胎儿期，但这是否适用于早产婴儿尚不清楚。
本研究的目的是评估小于胎龄（SGA）出生与早产婴儿后期肥胖和身高之间的关联。
截至2022年10月的MEDLINE、EMBASE和CINAHL数据库。
如果研究报告了SGA早产与非SGA早产参与者的人体测量学（肥胖指标和身高）结果，则纳入研究。由两名评审员进行重复筛选、数据提取和偏倚风险评估。
我们使用随机效应模型对各项研究进行荟萃分析，并探索潜在的异质性来源。
39项研究符合纳入标准。在成年后，与非SGA早产婴儿相比，SGA早产婴儿的体重指数较低（-0.66kg/m²，95%CI -0.79，-0.53；32项研究，I² = 16.7，n = 30346）、腰围较小（-1.20cm，95%CI -2.17，-0.23；13项研究，I² = 19.4，n = 2061）、瘦体重较低（-2.62kg，95%CI -3.45，-1.80；7项研究，I² = 0，n = 205）和身高较矮（-3.85cm，95%CI -4.73，-2.96；26项研究，I² = 52.6，n = 4174）。SGA早产组和非SGA早产组在腰臀比、体脂、体脂百分比、躯干脂肪百分比、脂肪量指数或瘦体重指数方面没有差异，尽管某些分析的检验效能有限。由于潜在的残余混杂因素，研究被评为高偏倚风险，在其他领域为低偏倚风险。
与非SGA早产同龄人相比，SGA早产婴儿在成年后的体重指数、腰围、瘦体重和身高较低。SGA早产婴儿和非SGA早产婴儿在肥胖方面没有差异。
