Women's Health and Allied Health Professional Theme, Karolinska University Hospital, Solna, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Clin Nutr ESPEN. 2024 Oct;63:727-735. doi: 10.1016/j.clnesp.2024.08.002. Epub 2024 Aug 20.
BACKGROUND & AIMS: Previous studies have observed changes in fat and fat-free mass among preterm infants when compared to term-born infants. However, these studies have mainly focused on moderate or very preterm infants, with a scope limited to the first few years of life. We aimed to compare body composition in extremely preterm infants to term-born infants in early childhood. Additionally, we investigated whether early neonatal nutrition was associated with the distribution of fat- and fat-free mass in later life.
The study used dual-energy x-ray absorptiometry to evaluate the body composition of 52 children aged 6-9-years, of whom 35 were born extremely preterm and 17 were born at term and was analyzed using multivariate linear regression. Nutritional intakes of fluids, energy, and macronutrients during the first eight postnatal weeks for 26 extremely preterm infants were investigated in relation to body composition at age 6-9 years using Bayesian regression analysis and Gradient Boosting Machine.
Children born extremely preterm had smaller head circumference (confidence interval -8.7 to -1.7), shorter height (confidence interval -2.7 to -0.6), higher waist to height ratio (confidence interval 0.01-0.05) and lower fat-free mass (confidence interval -3.9 to -0.49), compared to children born at full-term. Children born extremely preterm had a differing response to amount of fluid and macronutrient intake for both fat mass index and fat-free mass index. A bimodal response showed high intake of fluid and macronutrients as associated with high fat mass index for some children, whereas others demonstrated an inverse association, suggesting analysis on cohort-level as problematic.
Childhood body composition differs between extremely preterm infants and term-born infants. Extremely preterm infants display differing responses in their body composition to varying levels of fluids and macronutrient intake during the neonatal period.
与足月出生的婴儿相比，先前的研究观察到早产儿的体脂和去脂体重发生了变化。然而，这些研究主要集中在中度或极早产儿，其范围仅限于生命的最初几年。我们旨在比较极低出生体重早产儿和足月出生婴儿在幼儿期的身体成分。此外，我们还研究了新生儿早期营养是否与后期生活中脂肪和去脂体重的分布有关。
本研究使用双能 X 射线吸收法评估了 52 名 6-9 岁儿童的身体成分，其中 35 名是早产儿，17 名是足月出生的婴儿，并使用多元线性回归进行了分析。通过贝叶斯回归分析和梯度提升机，研究了 26 名极低出生体重早产儿在出生后 8 周内的液体、能量和宏量营养素摄入与 6-9 岁时的身体成分之间的关系。
与足月出生的婴儿相比，极低出生体重的婴儿头围较小（置信区间-8.7 至-1.7），身高较短（置信区间-2.7 至-0.6），腰高比更高（置信区间 0.01-0.05），去脂体重较低（置信区间-3.9 至-0.49）。极低出生体重的婴儿对液体和宏量营养素摄入的量对脂肪质量指数和去脂体重指数的反应不同。高液体和宏量营养素摄入与一些儿童的高脂肪质量指数相关，而另一些儿童则表现出相反的关联，这表明在队列水平上进行分析存在问题。
极低出生体重早产儿和足月出生婴儿的儿童期身体成分不同。极低出生体重的婴儿在新生儿期对液体和宏量营养素摄入水平的变化表现出不同的身体成分反应。
