Fetal overgrowth and weight trajectories during infancy and adiposity in early childhood

Min-Yi Tao; Xin Liu; Zi-Lin Chen; Meng-Nan Yang; Ya-Jie Xu; Hua He; Fang Fang; Qian Chen; Xuan-Xia Mao; Jun Zhang; Fengxiu Ouyang; Xiu-Hua Shen; Fei Li; Zhong-Cheng Luo; Shanghai Birth Cohort; Xiaoming Shen; Hong Huang; Kun Sun; Jun Zhang; Weiye Wang; Weiping Xu; Fengxiu Ouyang; Fei Li; Yin Huang; Jinsong Zhang; Chonghuai Yan; Lisong Shen; Yixiao Bao; Ying Tian; Weiwei Chen; Huijuan Zhang; Chuanliang Tong; Jian Xu; Lin Zhang; Yiwen Zhang; Fang Jiang; Xiaodan Yu; Guangjun Yu; Jinjin Chen; Yu Zhang; Xiaotian Li; Haidong Cheng; Qinying Zhang; Tao Duan; Jing Hua; Hua Peng

doi:10.1038/s41390-023-02991-7

Fetal overgrowth and weight trajectories during infancy and adiposity in early childhood

Pediatr Res. 2024 Apr;95(5):1372-1378. doi: 10.1038/s41390-023-02991-7. Epub 2024 Jan 10.

Authors

Min-Yi Tao^#^{1

2}, Xin Liu^#¹, Zi-Lin Chen¹, Meng-Nan Yang¹, Ya-Jie Xu¹, Hua He¹, Fang Fang¹, Qian Chen¹, Xuan-Xia Mao^{3

4}, Jun Zhang¹, Fengxiu Ouyang¹, Xiu-Hua Shen^{5

6}, Fei Li⁷, Zhong-Cheng Luo^{8

9}; Shanghai Birth Cohort; Xiaoming Shen¹⁰, Hong Huang¹⁰, Kun Sun¹⁰, Jun Zhang¹⁰, Weiye Wang¹⁰, Weiping Xu¹⁰, Fengxiu Ouyang¹⁰, Fei Li¹⁰, Yin Huang¹⁰, Jinsong Zhang¹⁰, Chonghuai Yan¹⁰, Lisong Shen¹⁰, Yixiao Bao¹⁰, Ying Tian¹¹, Weiwei Chen¹², Huijuan Zhang¹², Chuanliang Tong¹², Jian Xu¹², Lin Zhang¹², Yiwen Zhang¹³, Fang Jiang¹³, Xiaodan Yu¹³, Guangjun Yu¹⁴, Jinjin Chen¹⁴, Yu Zhang¹⁵, Xiaotian Li¹⁶, Haidong Cheng¹⁶, Qinying Zhang¹⁶, Tao Duan¹⁷, Jing Hua¹⁶, Hua Peng¹⁸

Affiliations

¹ Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China.
² Lunenfeld-Tanenbaum Research Institute, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerity Faculty of Medicine, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5G 1X5, Canada.
³ Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
⁴ Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
⁵ Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. srachel@126.com.
⁶ Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. srachel@126.com.
⁷ Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China. feili@shsmu.edu.cn.
⁸ Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China. zc.luo@utoronto.ca.
⁹ Lunenfeld-Tanenbaum Research Institute, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerity Faculty of Medicine, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5G 1X5, Canada. zc.luo@utoronto.ca.
¹⁰ Xinhua Hospital and Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹¹ School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹² International Peace Maternity and Child Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹³ Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹⁴ Shanghai Children's Hospital, Shanghai, China.
¹⁵ Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹⁶ Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
¹⁷ Shanghai First Maternity and Infant Care Hospital, Tong Ji University, Shanghai, China.
¹⁸ Maternal and Child Health Institute of Yangpu District, Shanghai, China.

^# Contributed equally.

PMID: 38200323
DOI: 10.1038/s41390-023-02991-7

Abstract

Background: Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood. Little is known about how infancy growth trajectories affect adiposity in early childhood in LGA.

Methods: In the Shanghai Birth Cohort, we followed up 259 LGA (birth weight >90th percentile) and 1673 appropriate-for-gestational age (AGA, 10th-90th percentiles) children on body composition (by InBody 770) at age 4 years. Adiposity outcomes include body fat mass (BFM), percent body fat (PBF), body mass index (BMI), overweight/obesity, and high adiposity (PBF >85th percentile).

Results: Three weight growth trajectories (low, mid, and high) during infancy (0-2 years) were identified in AGA and LGA subjects separately. BFM, PBF and BMI were progressively higher from low- to mid-to high-growth trajectories in both AGA and LGA children. Compared to the mid-growth trajectory, the high-growth trajectory was associated with greater increases in BFM and the odds of overweight/obesity or high adiposity in LGA than in AGA children (tests for interactions, all P < 0.05).

Conclusions: Weight trajectories during infancy affect adiposity in early childhood regardless of LGA or not. The study is the first to demonstrate that high-growth weight trajectory during infancy has a greater impact on adiposity in early childhood in LGA than in AGA subjects.

Impact: Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood, but little is known about how weight trajectories during infancy affect adiposity during early childhood in LGA subjects. The study is the first to demonstrate a greater impact of high-growth weight trajectory during infancy (0-2 years) on adiposity in early childhood (at age 4 years) in subjects with fetal overgrowth (LGA) than in those with normal birth size (appropriate-for-gestational age). Weight trajectory monitoring may be a valuable tool in identifying high-risk LGA children for close follow-ups and interventions to decrease the risk of obesity.