Newborn body composition and child cardiovascular risk markers: a prospective multi-ethnic Asian cohort study

Yi Ying Ong; Mya-Thway Tint; Izzuddin M Aris; Wen Lun Yuan; Ling-Wei Chen; Marielle V Fortier; Jonathan Choo; Lieng Hsi Ling; Lynette Shek; Kok Hian Tan; Peter D Gluckman; Fabian Yap; Yap-Seng Chong; Keith M Godfrey; Mary F-F Chong; Shiao-Yng Chan; Johan G Eriksson; Mary E Wlodek; Emanuella De Lucia Rolfe; Ken K Ong; Navin Michael; Yung Seng Lee

doi:10.1093/ije/dyac154

Newborn body composition and child cardiovascular risk markers: a prospective multi-ethnic Asian cohort study

Int J Epidemiol. 2022 Dec 13;51(6):1835-1846. doi: 10.1093/ije/dyac154.

Authors

Yi Ying Ong¹, Mya-Thway Tint^{2

3}, Izzuddin M Aris⁴, Wen Lun Yuan¹, Ling-Wei Chen^{3

5}, Marielle V Fortier^{3

6}, Jonathan Choo⁷, Lieng Hsi Ling⁸, Lynette Shek^{1

3

9}, Kok Hian Tan^{10

11}, Peter D Gluckman^{3

12}, Fabian Yap^{7

10}, Yap-Seng Chong^{2

3}, Keith M Godfrey¹³, Mary F-F Chong^{3

14}, Shiao-Yng Chan^{2

3}, Johan G Eriksson^{2

3

15

16}, Mary E Wlodek^{2

3}, Emanuella De Lucia Rolfe¹⁷, Ken K Ong¹⁷, Navin Michael³, Yung Seng Lee^{1

3

9}

Affiliations

¹ Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
² Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
³ Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore.
⁴ Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
⁵ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁶ Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore.
⁷ Department of Paediatrics, KK Women's and Children's Hospital, Singapore.
⁸ Department of Cardiology, National University Heart Centre, Singapore.
⁹ Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, Singapore.
¹⁰ Academic Medicine Department, Duke-NUS Medical School, Singapore.
¹¹ Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.
¹² Liggins Institute, University of Auckland, Auckland, New Zealand.
¹³ MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹⁴ Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
¹⁵ Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
¹⁶ Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland.
¹⁷ Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.

Abstract

Background: Early epidemiological studies have associated low birthweight with increased cardiovascular risk. We aimed to examine whether the fat and fat-free components of birthweight have differing relationships with childhood cardiovascular risk markers.

Methods: In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, air displacement plethysmography was conducted within 24 h after delivery in 290 naturally conceived singletons. We investigated associations of newborn cohort-specific standardized z-score of fat mass, fat-free mass, body fat percentage and birthweight on child (at 6 years of age) carotid intima-media thickness, pulse wave velocity, blood pressure, prehypertension/hypertension (>110/70 mmHg) and standardized systolic and diastolic blood pressure (SBP and DBP) trajectories (at 3-6 years of age), taking account of maternal education, height, tobacco exposure, parity, ethnicity, child's sex, gestational age, age at follow-up, and other maternal factors.

Results: Clear inverse associations were seen for blood pressure with z-score of fat mass [SBP, β (95% CI): -1.31 mmHg (-2.57, -0.06); DBP: -0.79 mmHg (-1.74, 0.15)] and body fat percentage [SBP: -1.46 mmHg (-2.73, -0.19); DBP: -0.80 mmHg (-1.75, 0.16)], but not with fat-free mass [SBP: 0.27 mmHg (-1.29, 1.83)]; DBP: -0.14 mmHg (-1.30, 1.03)]. Being in the lowest tertile of fat mass or body fat percentage was associated with higher blood pressure trajectories and prehypertension/hypertension risk [OR (95% CI), fat mass: 4.23 (1.41, 12.68); body fat percentage: 3.22 (1.09, 9.53)] without concomitantly higher overweight/obesity risk.

Conclusions: At birth, low adiposity was associated with increased childhood blood pressure. Low newborn adiposity might serve as a marker of poor fetal growth or suboptimal intrauterine conditions associated with hypertension risk later in life.

Keywords: Adiposity; birthweight; blood pressure; cardiovascular; fetal growth.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Weight
Blood Pressure
Body Composition
Body Mass Index
Cardiovascular Diseases* / epidemiology
Carotid Intima-Media Thickness
Child
Child, Preschool
Cohort Studies
Female
Heart Disease Risk Factors
Humans
Hypertension* / epidemiology
Infant, Newborn
Obesity
Pregnancy
Prehypertension*
Prospective Studies
Pulse Wave Analysis
Risk Factors

Abstract

Publication types

MeSH terms

Grants and funding