title: Small for gestational age and higher birth weight predict childhood obesity in preterm infants.
abstract: We sought to determine the association between small for gestational age (SGA), birth weight, and childhood obesity within preterm polysubstance exposed children. We sampled 312 preterm children with 11-year body mass index (BMI; age- and sex-specific) data from the Maternal Lifestyle Study (51% girls, 21.5% SGA, 46% prenatal cocaine, and 55% tobacco exposed). Multinomial regression analyzed the association between 11-year obesity (OBE) and overweight (OW) and SGA, birth weight, first-year growth velocity, diet, and physical activity variables. Overall, 24% were OBE (BMI for age ≥95th percentile) and 16.7% were OW (BMI ≥85th and <95th percentiles). In adjusted analyses, SGA was associated with OW (odds ratio [OR] = 3.4, confidence interval [CI] 1.5 to 7.5). Higher birth weight was associated with OBE (OR = 1.8, CI 1.3 to 2.4) and OW (OR = 1.4, CI 1.1 to 2.0). Growth velocity was associated with OBE (OR = 2.7, CI 1.8 to 4.0) and OW (OR = 1.6, CI 1.1 to 2.4). Low exercise was associated with OBE (OR = 2.1, CI 1.0 to 4.4) and OW (OR = 2.1, CI 1.0 to 4.5). There was no effect of substance exposure on obesity outcomes. Many (41%) of these high-risk preterm 11-year-olds were obese/overweight. Multiple growth-related processes may be involved in obesity risk for preterm children, including fetal programming as indicated by the SGA effect.
authors.affiliation: Center for Study of Children at Risk, Brown-Alpert Medical School, Women & Infants Hospital of Rhode Island, Providence, Rhode Island 02905, USA. Ronnesia_Gaskins@brown.edu
authors.forename: Ronnesia B
authors.initials: RB
authors.lastname: Gaskins
authors.forename: Linda L
authors.initials: LL
authors.lastname: LaGasse
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.forename: Barry M
authors.initials: BM
authors.lastname: Lester
authors.forename: Henrietta S
authors.initials: HS
authors.lastname: Bada
authors.forename: Charles R
authors.initials: CR
authors.lastname: Bauer
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
authors.forename: Mary
authors.initials: M
authors.lastname: Roberts
mesh_terms: D015992:Body Mass Index; D015984:Causality; D002648:Child; D002675:Child, Preschool; D005260:Female; D047109:Fetal Development / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007236:Infant, Small for Gestational Age / Q000502:physiology; D008137:Longitudinal Studies; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D050177:Overweight / Q000453:epidemiology / Q000209:etiology; D011203:Poverty; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D012307:Risk Factors
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