Title

Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort

Authors

Betty R. Vohr, The Warren Alpert Medical School
Roy Heyne, UT Southwestern Medical School
Carla M. Bann, RTI International
Abhik Das, RTI International
Rosemary D. Higgins, National Institute of Child Health and Human Development (NICHD)
Susan R. Hintz, Stanford University School of Medicine
Alan H. Jobe, University of Cincinnati
Michael S. Caplan, Pritzker School of Medicine
Richard A. Polin, Columbia University in the City of New York
Abbot R. Laptook, Women and Infants Hospital of Rhode Island
Angelita M. Hensman, Women and Infants Hospital of Rhode Island
Elisabeth C. McGowan, Women and Infants Hospital of Rhode Island
Elisa Vieira, Women and Infants Hospital of Rhode Island
Emilee Little, Women and Infants Hospital of Rhode Island
Katharine Johnson, Women and Infants Hospital of Rhode Island
Barbara Alksninis, Women and Infants Hospital of Rhode Island
Mary Lenore Keszler, Women and Infants Hospital of Rhode Island
Andrea M. Knoll, Women and Infants Hospital of Rhode Island
Theresa M. Leach, Women and Infants Hospital of Rhode Island
Victoria E. Watson, Women and Infants Hospital of Rhode Island
Michele C. Walsh, Case Western Reserve University
Avroy A. Fanaroff, Case Western Reserve University
Deanne E. Wilson-Costello, Case Western Reserve University
Allison Payne, Case Western Reserve University
Nancy S. Newman, Case Western Reserve University
H. Gerry Taylor, Case Western Reserve University
Bonnie S. Siner, Case Western Reserve University
Arlene Zadell, Case Western Reserve University
Julie DiFiore, Case Western Reserve University
Monika Bhola, Case Western Reserve University
Harriet G. Friedman, Case Western Reserve University
Gulgun Yalcinkaya, Case Western Reserve University
Dorothy Bulas, Childrens National Health System

Document Type

Journal Article

Publication Date

9-1-2018

Journal

Journal of Pediatrics

Volume

200

DOI

10.1016/j.jpeds.2018.04.073

Keywords

hypertension; obese; overweight; preterm; school age; sedentary activity

Abstract

© 2018 Elsevier Inc. Objective: To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. Study design: Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed. Three groups were compared, those with a BMI ≥85th percentile (overweight or obese for age, height, and sex) and ≥95th percentile (obese) vs <85th percentile. Multiple regression analyses estimated the relative risks of BMI ≥85th percentile and ≥95th percentile associated with perinatal and early childhood factors. Results: Of 388 children, 22% had a BMI of ≥85th percentile and 10% were obese. Children with obesity and overweight compared with normal weight children had higher body fat (subscapular skinfold and triceps skinfold >85th percentile), central fat (waist circumference >90th percentile), spent more time in sedentary activity (20.5 vs 18.2 vs 16.7 hours/week), and had either systolic and/or diastolic hypertension (24% vs 26% vs 14%), respectively. Postdischarge weight gain velocities from 36 weeks postmenstrual age to 18 months, and 18 months to 6-7 years were independently associated with a BMI of ≥85th percentile, whereas weight gain velocity from 18 months to 6-7 years was associated with obesity. Conclusions: One in 5 former extremely preterm infants is overweight or obese and has central obesity at early school age. Postdischarge weight gain velocities were associated with overweight and obesity. These findings suggest the obesity epidemic is spreading to the most extremely preterm infants. Trial registration: ClinicalTrials.gov: NCT00063063 and NCT0000.

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