Body composition at birth and its relationship with neonatal anthropometric ratios: the newborn body composition study of the INTERGROWTH-21st project

José Villar; Fabien A Puglia; Tanis R Fenton; Leila Cheikh Ismail; Eleonora Staines-Urias; Francesca Giuliani; Eric O Ohuma; Cesar G Victora; Peter Sullivan; Fernando C Barros; Ann Lambert; Aris T Papageorghiou; Roseline Ochieng; Yasmin A Jaffer; Douglas G Altman; Alison J Noble; Michael G Gravett; Manorama Purwar; Ruyan Pang; Ricardo Uauy; Stephen H Kennedy; Zulfiqar A Bhutta

doi:10.1038/pr.2017.52

Body composition at birth and its relationship with neonatal anthropometric ratios: the newborn body composition study of the INTERGROWTH-21^st project

Pediatr Res. 2017 Aug;82(2):305-316. doi: 10.1038/pr.2017.52. Epub 2017 May 31.

Authors

José Villar¹, Fabien A Puglia¹, Tanis R Fenton², Leila Cheikh Ismail¹, Eleonora Staines-Urias¹, Francesca Giuliani³, Eric O Ohuma¹, Cesar G Victora⁴, Peter Sullivan⁵, Fernando C Barros⁶, Ann Lambert¹, Aris T Papageorghiou¹, Roseline Ochieng⁷, Yasmin A Jaffer⁸, Douglas G Altman⁹, Alison J Noble¹⁰, Michael G Gravett¹¹, Manorama Purwar¹², Ruyan Pang¹³, Ricardo Uauy¹⁴, Stephen H Kennedy¹, Zulfiqar A Bhutta¹⁵

Affiliations

¹ Nuffield Department of Obstetrics and Gynaecology and Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.
² Department of Community Health Sciences, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
³ Dipartimento di Scienze Pediatriche e dell'Adolescenza, Cattedra di Neonatologia, Università degli Studi di Torino, Torino, Italy.
⁴ Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.
⁵ Department of Paediatrics, University of Oxford, Oxford, UK.
⁶ Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil.
⁷ Faculty of Health Sciences, Aga Khan University, Nairobi, Kenya.
⁸ Department of Family and Community Health, Ministry of Health, Muscat, Sultanate of Oman.
⁹ Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
¹⁰ Department of Engineering Science, University of Oxford, Oxford, UK.
¹¹ Global Alliance to Prevent Prematurity and Stillbirth, Seattle, Washington.
¹² Nagpur INTERGROWTH-21 Research Centre, Ketkar Hospital, Nagpur, India.
¹³ School of Public Health, Peking University, Beijing, China.
¹⁴ Division of Paediatrics, School of Medicine, Pontifical Universidad Católica de Chile, Santiago, Chile.
¹⁵ Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.

Abstract

BackgroundWe aimed to describe newborn body composition and identify which anthropometric ratio (weight/length; BMI; or ponderal index, PI) best predicts fat mass (FM) and fat-free mass (FFM).MethodsAir-displacement plethysmography (PEA POD) was used to estimate FM, FFM, and body fat percentage (BF%). Associations between FFM, FM, and BF% and weight/length, BMI, and PI were evaluated in 1,019 newborns using multivariate regression analysis. Charts for FM, FFM, and BF% were generated using a prescriptive subsample (n=247). Standards for the best-predicting anthropometric ratio were calculated utilizing the same population used for the INTERGROWTH-21^st Newborn Size Standards (n=20,479).ResultsFFM and FM increased consistently during late pregnancy. Differential FM, BF%, and FFM patterns were observed for those born preterm (34⁺⁰-36⁺⁶ weeks' gestation) and with impaired intrauterine growth. Weight/length by gestational age (GA) was a better predictor of FFM and FM (adjusted R²=0.92 and 0.71, respectively) than BMI or PI, independent of sex, GA, and timing of measurement. Results were almost identical when only preterm newborns were studied. We present sex-specific centiles for weight/length ratio for GA.ConclusionsWeight/length best predicts newborn FFM and FM. There are differential FM, FFM, and BF% patterns by sex, GA, and size at birth.

MeSH terms

Adult
Anthropometry*
Body Composition*
Female
Growth
Humans
Infant, Newborn
Male
Pregnancy