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Critical examination of relationships between early growth and childhood overweight in extremely preterm infants

Journal of Perinatology volume 41, pages 2774–2781 (2021)Cite this article

Subjects

Abstract

Objectives

To identify the prevalence and risk factors for childhood overweight and obesity (OWO) at 3-year corrected age in children born <1500 g <29 weeks gestation.

Study design

A multicentre retrospective cohort study for preterm infants admitted to neonatal intensive care units between 2001 and 2014.

Results

Data were available for 911 (89.4%) of the 1019 infants who met the inclusion criteria. Of them, 22 (2.4%) had OWO. There were no associations between OWO and being small for gestational age (RR = 1.3, 95% confidence interval (CI): 0.3–5.4) or weight <10th percentile at 36 weeks (RR = 1.1, 95% CI: 0.4–2.8). OWO was associated with low maternal education (RR = 7.4, 95% CI: 2.1–26), maternal diabetes (RR = 5.2, 95% CI: 1.9–15) and neonatal brain injury (RR = 4.9, 95% CI: 1.8–14). Adjusting for concurrent child weight at 3 years of age resulted in an overadjustment bias.

Conclusion

Small size at birth or at 36 weeks gestation in extremely preterm infants is not associated with increased risk of early childhood overgrowth or obesity.

Clinical trial registration

NCT03064022.

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Fig. 1: The children’s body mass indexes (BMIs) at 3 years.
Fig. 2: Growth patterns of the overweight and non-overweight children.

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Acknowledgements

We wish to thank the Neonatologists, Nurses, Dietitians, and other staff who cared for the infants in this study, and the parents who provided consent for their infants’ data to be used in research. We thank Megan Ramsay, Ninfa Garay, Michelle Matiation, Sara Leuenberger, Jasmine Shourounis, Tian Huang for their excellent data collection and Lynn Rotariu and Kim Fichter from Health Records.

Funding

This work was supported by the Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Canada, and the Canadian Foundation for Dietetic Research.

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Authors and Affiliations

  1. Community Health Sciences, O’Brien Institute of Public Health, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Tanis R. Fenton, Seham Elmrayed, Chelsia Gillis & Belal Alshaikh

  2. Nutrition Services, Alberta Health Services, Calgary, AB, Canada

    Tanis R. Fenton

  3. Nutrition and Food Services, Saskatchewan Health Authority, Regina, SK, Canada

    Roseann Nasser

  4. Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Dianne Creighton & Belal Alshaikh

  5. Alberta Children’s Hospital Neonatal Follow-up Clinic, Alberta Health Services, Calgary, AB, Canada

    Selphee Tang

  6. Department of Obstetrics and Gynecology, Alberta Health Services, Calgary, AB, Canada

    Selphee Tang

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Contributions

TRF conceptualized and designed the study with assistance from all the other authors, performed the statistical analysis, drafted the initial manuscript, and reviewed and revised the manuscript. All the other authors made substantial contributions to the conception or design of the work or the acquisition, analysis, and/or interpretation of data. All authors revised it critically for important intellectual content and approved the final of the version to be published.

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Correspondence to Tanis R. Fenton.

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Fenton, T.R., Nasser, R., Creighton, D. et al. Critical examination of relationships between early growth and childhood overweight in extremely preterm infants. J Perinatol 41, 2774–2781 (2021). https://doi.org/10.1038/s41372-021-01182-8

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