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Baroni NF, Carvalho MR, da Silva Santos I, Chaves AVL, de Andrade Miranda DEG, Crivellenti LC, Sartorelli DS. Effect of a lifestyle intervention among pregnant women with overweight on neonatal adiposity: A randomized controlled clinical trial. Early Hum Dev 2024; 194:106038. [PMID: 38776727 DOI: 10.1016/j.earlhumdev.2024.106038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The excess neonatal adiposity is considered a risk factor for the development of childhood obesity and the birth weight is a marker of health throughout life. AIMS To evaluate the effect of a lifestyle intervention conducted among pregnant women with overweight on neonatal adiposity and birth weight. METHODS A total of 350 pregnant women were recruited and randomly allocated into the control (CG) and intervention (IG) groups. Pregnant women in the IG were invited to participate in three nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed foods, following the NOVA food classification system, which categorizes foods according to the extent and purpose of industrial processing, and the regular practice of physical activity. Neonatal adiposity was estimated using a previously validated anthropometric model. Adjusted linear regression models were used to measure the effect. RESULTS Adopting the modified intention-to-treat principle, data from 256 neonates were analyzed for birth weight, and data from 163 for body composition estimation. The treatment had no effect on the proportion of fat mass [β 0.52 (95 % CI -1.03, 2.06); p = .51], fat-free mass [β -0.50 (95 % CI -2.45, 1.45); p = .61] or birth weight [β 53.23 (95 % CI -87.19, 193.64); p = .46]. CONCLUSIONS In the present study, the lifestyle counselling used had no effect on neonatal adiposity or birth weight. Future studies should investigate the effect of more intensive interventions.
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Affiliation(s)
- Naiara Franco Baroni
- Postgraduate Program in Public Health, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto, SP, Brazil
| | - Mariana Rinaldi Carvalho
- Postgraduate Program in Public Health, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto, SP, Brazil
| | - Izabela da Silva Santos
- Postgraduate Program in Nutrition and Metabolism, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto, SP, Brazil
| | - Ana Vitória Lanzoni Chaves
- Postgraduate Program in Public Health, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto, SP, Brazil
| | | | - Lívia Castro Crivellenti
- Postgraduate Program in Public Health, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto, SP, Brazil
| | - Daniela Saes Sartorelli
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto, SP, Brazil.
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Alkhatib A, Obita G. Childhood Obesity and Its Comorbidities in High-Risk Minority Populations: Prevalence, Prevention and Lifestyle Intervention Guidelines. Nutrients 2024; 16:1730. [PMID: 38892662 PMCID: PMC11175158 DOI: 10.3390/nu16111730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
The prevalence of childhood obesity and its associated comorbidities is a growing global health problem that disproportionately affects populations in low- and middle-income countries (LMICs) and minority ethnicities in high-income countries (HICs). The increased childhood obesity disparities among populations reflect two concerns: one is HICs' ineffective intervention approaches in terms of lifestyle, nutrition and physical activity in minority populations, and the second is the virtually non-existent lifestyle obesity interventions in LMICs. This article provides guidelines on childhood obesity and its comorbidities in high-risk minority populations based on understanding the prevalence and effectiveness of preventative lifestyle interventions. First, we highlight how inadequate obesity screening by body mass index (BMI) can be resolved by using objective adiposity fat percentage measurements alongside anthropometric and physiological components, including lean tissue and bone density. National healthcare childhood obesity prevention initiatives should embed obesity cut-off points for minority ethnicities, especially Asian and South Asian ethnicities within UK and USA populations, whose obesity-related metabolic risks are often underestimated. Secondly, lifestyle interventions are underutilised in children and adolescents with obesity and its comorbidities, especially in minority ethnicity population groups. The overwhelming evidence on lifestyle interventions involving children with obesity comorbidities from ethnic minority populations shows that personalised physical activity and nutrition interventions are successful in reversing obesity and its secondary cardiometabolic disease risks, including those related to cardiorespiratory capacity, blood pressure and glucose/insulin levels. Interventions combining cultural contextualisation and better engagement with families are the most effective in high-risk paediatric minority populations but are non-uniform amongst different minority communities. A sustained preventative health impact can be achieved through the involvement of the community, with stakeholders comprising healthcare professionals, nutritionists, exercise science specialists and policy makers. Our guidelines for obesity assessment and primary and secondary prevention of childhood obesity and associated comorbidities in minority populations are fundamental to reducing global and local health disparities and improving quality of life.
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Affiliation(s)
- Ahmad Alkhatib
- College of Life Sciences, Birmingham City University, City South Campus, Edgbaston, Birmingham B15 3TN, UK
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK;
| | - George Obita
- School of Health and Life Sciences, Teesside University, Tees Valley, Middlesbrough TS1 3BX, UK;
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3
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Gomes J, Begum M, Kumarathasan P. Polybrominated diphenyl ether (PBDE) exposure and adverse maternal and infant health outcomes: Systematic review. CHEMOSPHERE 2024; 347:140367. [PMID: 37890790 DOI: 10.1016/j.chemosphere.2023.140367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023]
Abstract
Polybrominated diphenyl ethers (PBDEs) are flame retardants found in ambient environment and are measured in humans. There are reports on general PBDE toxicity, including endocrine disrupting properties. Studies on adverse maternal and infant outcomes and underlying toxicity mechanisms needs to be understood. The objective of this study was to conduct a systematic review to examine the state of science on the relationship between PBDE and adverse maternal/infant health outcomes and related maternal biomarker changes. This literature review was conducted using PubMed, Scopus, Embase and Web of Science for published articles from January 2005-February 2022. Article quality was assessed using Newcastle-Ottawa Scale. Of the 1518 articles, only 54 human observational studies were screened in for this review. A second reviewer examined the validity of these articles. Reports on associations between PBDE and maternal health outcomes included gestational hypertension/preeclampsia (N = 2) and gestational diabetes mellitus/glycemic index (N = 6). Meanwhile, reports on PBDE and infant outcomes (N=32) included effects on infant birth weight, birth length and cephalic perimeter, preterm birth, fetal growth restriction and APGAR scores. Although findings on PBDE exposure and adverse infant outcomes showed inconsistencies across studies, in general, negative correlations between maternal PBDEs and infant birth weight, birth length and cephalic perimeter were seen, in few cases, after stratification by sex. Association between maternal PBDE and maternal biomarkers (N=18) suggested negative impact of PBDE exposure on markers relevant to neuro-endocrine system and inflammatory processes. The review findings identified potential associations between maternal PBDE and adverse maternal/infant health outcomes. Furthermore, PBDE-related biomarker changes suggest disturbances in maternal mechanisms relevant to endocrine disrupting properties of PBDEs. The observed study heterogeneity can be attributed to factors namely, sample size, study design and statistical analysis. Overall review findings imply the necessity for further research to validate PBDE exposure-related adverse maternal/infant health effects and to validate underlying toxicity mechanisms.
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Affiliation(s)
- J Gomes
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - M Begum
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - P Kumarathasan
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; Environmental Health Science and Research Bureau, HECS, Health Canada, Ottawa, ON, Canada.
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Marano D, Couto EDO, Amaral YNDVD, Junior SCG, Ramos EG, Moreira MEL. Development of a predictive model of body fat mass for newborns and infants. Nutrition 2023; 114:112133. [PMID: 37499562 DOI: 10.1016/j.nut.2023.112133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/14/2023] [Accepted: 06/11/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES The aim of this study is to develop predictive body fat mass models, one for newborns and one for infants, using air displacement plethysmography as a reference method. METHODS The study was carried out with 125 newborns (1-5 d of age) and 71 infants (≥3-6 mo). The stepwise method was used to estimate the final model from the predictors of sex, weight, length, triceps skinfold, waist circumference, mean arm circumference, and gestational age. The quality of the models was evaluated by the determination coefficient, variance inflation factor, and residual analysis. The paired t test and Bland-Altman plot were used to assess the agreement between observed and estimated values. RESULTS The final model for newborns was - 0.76638 + 0.2512 * weight (kg) + 0.0620 * PCT (mm) + 0.0754 * gender (R² = 70%) and the final model for infants: -2.22748 + 0.4928 * weight (kg) + 0.0737 * TSF (mm) + 0.2647 * gender (R² = 84%). CONCLUSIONS This work determined equations to estimate the BFM of term newborns and infants. The models can be used in clinical practice, especially in health units without access to technologies for measuring body composition, adding important information for nutritional monitoring.
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Affiliation(s)
- Daniele Marano
- Clinical Research Unit, Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Elissa de Oliveira Couto
- Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Saint Clair Gomes Junior
- Clinical Research Unit, Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eloane Gonçalves Ramos
- Clinical Research Unit, Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Maria Elisabeth Lopes Moreira
- Clinical Research Unit, Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Stevens DR, Yeung E, Hinkle SN, Grobman W, Williams A, Ouidir M, Kumar R, Lipsky LM, Rohn MCH, Kanner J, Sherman S, Chen Z, Mendola P. Maternal asthma in relation to infant size and body composition. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100122. [PMID: 37485032 PMCID: PMC10361394 DOI: 10.1016/j.jacig.2023.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Background Asthma affects 10% of pregnancies and may influence offspring health, including infant size and body composition, through hypoxic and inflammatory pathways. Objective We sought to determine associations between maternal asthma and asthma phenotypes during pregnancy and infant size and body composition. Methods The B-WELL-Mom study (2015-19) is a prospective cohort of 418 pregnant persons with and without asthma recruited in the first trimester of pregnancy from 2 US obstetric clinics. Exposures were maternal self-reported active asthma (n = 311) or no asthma (n = 107), and asthma phenotypes were classified on the bases of atopy, onset, exercise induced, control, severity, symptomology, and exacerbations. Outcomes were infant weight, length, head circumference, and skinfold measurements at birth and postnatal follow-up, as well as fat and lean mass assessed by air displacement plethysmography at birth. Adjusted multivariable linear regression examined associations of maternal asthma and asthma phenotypes with infant outcomes. Results Offspring were born at a mean ± SD of 38 ± 2.3 weeks' gestation and were 18 ± 2.2 weeks of age at postnatal follow-up. Infants of participants with asthma had a mean ± SD fat mass of 11.0 ± 4.2%, birth weight of 3045.8 ± 604.3 g, and postnatal follow-up weight of 6696.4 ± 964.2 g, which were not different from infants of participants without asthma (respectively, β [95% confidence interval]: -0.1 [-1.4, 1.3], -26.7 [-156.9, 103.4], and 107.5 [-117.3, 332.3]). Few associations were observed between asthma or asthma phenotypes and infant size or body composition. Conclusions In a current obstetric cohort, maternal asthma during pregnancy was not associated with differential infant size or body composition.
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Affiliation(s)
- Danielle R. Stevens
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
| | - Edwina Yeung
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
| | - Stefanie N. Hinkle
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | - Andrew Williams
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks
| | - Marion Ouidir
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
| | - Rajesh Kumar
- Feinberg School of Medicine, Northwestern University, Chicago
| | - Leah M. Lipsky
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
| | - Matthew C. H. Rohn
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
- Department of Obstetrics and Gynecology, George Washington University, Washington
| | - Jenna Kanner
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
| | | | - Zhen Chen
- Biostatistics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
| | - Pauline Mendola
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo
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Lucaccioni L, Palandri L, Passini E, Trevisani V, Calandra Buonaura F, Bertoncelli N, Talucci G, Ferrari A, Ferrari E, Predieri B, Facchinetti F, Iughetti L, Righi E. Perinatal and postnatal exposure to phthalates and early neurodevelopment at 6 months in healthy infants born at term. Front Endocrinol (Lausanne) 2023; 14:1172743. [PMID: 37293488 PMCID: PMC10244530 DOI: 10.3389/fendo.2023.1172743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Background Phthalates are non-persistent chemicals largely used as plasticizers and considered ubiquitous pollutants with endocrine disrupting activity. The exposure during sensible temporal windows as pregnancy and early childhood, may influence physiological neurodevelopment. Aims and Scope The aim of this study is to analyze the relationship between the urinary levels of phthalate metabolites in newborn and infants and the global development measured by the Griffiths Scales of Children Development (GSCD) at six months. Methods Longitudinal cohort study in healthy Italian term newborn and their mothers from birth to the first 6 months of life. Urine samples were collected at respectively 0 (T0), 3 (T3), 6 (T6) months, and around the delivery for mothers. Urine samples were analyzed for a total of 7 major phthalate metabolites of 5 of the most commonly used phthalates. At six months of age a global child development assessment using the third edition of the Griffith Scales of Child Development (GSCD III) was performed in 104 participants. Results In a total of 387 urine samples, the seven metabolites analyzed appeared widespread and were detected in most of the urine samples collected at any time of sampling (66-100%). At six months most of the Developmental Quotients (DQs) falls in average range, except for the subscale B, which presents a DQ median score of 87 (85-95). Adjusted linear regressions between DQs and urinary phthalate metabolite concentrations in mothers at T0 and in infants at T0, T3 and T6 identified several negative associations both for infants' and mothers especially for DEHP and MBzP. Moreover, once stratified by children's sex, negative associations were found in boys while positive in girls. Conclusions Phthalates exposure is widespread, especially for not regulated compounds. Urinary phthalate metabolites were found to be associated to GSCD III scores, showing inverse association with higher phthalate levels related to lower development scores. Our data suggested differences related to the child's sex.
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Affiliation(s)
- Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lucia Palandri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Erica Passini
- Post graduate School of Pediatrics, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Viola Trevisani
- Post graduate School of Pediatrics, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Natascia Bertoncelli
- Neonatology Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanna Talucci
- Neonatology Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Angela Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Eleonora Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Facchinetti
- Unit of Obstetrics and Gynecology, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
- Post graduate School of Pediatrics, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Righi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Aderibigbe OA, Lappen JR, Gibson KS. Body composition in term neonates of mothers with hypertensive disorders of pregnancy. Pediatr Res 2023; 93:1031-1035. [PMID: 35906316 DOI: 10.1038/s41390-022-02191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/28/2022] [Accepted: 06/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Neonates of gravidas with hypertensive disorders of pregnancy (HDP) are at increased lifelong risk of cardiometabolic complications. Neonatal adiposity measured by body composition (BC) is a better surrogate of nutritional status than birth weight. Data comparing BC in term neonates of hypertensive and normotensive pregnant patients is lacking. Our objective was to compare body composition in both groups of neonates. METHODS This was a retrospective cohort study from March 2018 to June 2019 at our tertiary institution where term neonatal BC are routinely measured. Neonates of patients with HDP and matched controls were included. Skin fold thickness (SFT) and percent body fat (PBF) were calculated using a validated anthropometric formula and compared using Mann-Whitney U and chi-square tests. RESULTS One hundred and forty-two neonates of patients with HDP were compared to 150 controls. Demographic characteristics were similar except for higher pre-pregnancy BMI (29.7 ± 8.4 vs 26.75 ± 7.1, p = <0.01) in the HDP group. SFT was not significantly different (4.6 vs 4.4 mm, p = 0.09) but PBF was higher in the hypertensive group (13.15 vs 11.72, p = 0.01). CONCLUSIONS PBF is higher in neonates of mothers with HDP, which may contribute to an increased risk of cardiometabolic complications later in life. IMPACT Birth weight percentiles do not explain the predisposition to cardiovascular complications in offspring of hypertensive mothers. Body composition estimation may provide an explanation for this increased risk. Percent body fat is higher in term neonates of mothers with hypertensive disorders of pregnancy than neonates of normotensive mothers. Body composition is different in term neonates of mothers with hypertensive disorders of pregnancy.
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Affiliation(s)
- Oluyemi A Aderibigbe
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH, USA.
- Department of Reproductive Biology, Division of Maternal-Fetal Medicine, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH, USA.
| | - Justin R Lappen
- Department of Reproductive Biology, Division of Maternal-Fetal Medicine, Cleveland Clinic Lerner College of Medicine/Case Western Reserve University, Cleveland, OH, USA
| | - Kelly S Gibson
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH, USA
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Prior E, Uthaya SN, Gale C. Measuring body composition in children: research and practice. Arch Dis Child Educ Pract Ed 2023:archdischild-2022-324920. [PMID: 36813541 DOI: 10.1136/archdischild-2022-324920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/14/2022] [Indexed: 02/24/2023]
Affiliation(s)
- Emily Prior
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College, London, UK
| | - Sabita N Uthaya
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College, London, UK.,Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College, London, UK
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Nel S, Feucht UD, Mulol H, Wenhold FA. Association of Prenatal Placental Function with Anthropometry and Body Composition through 2 years of Age in South African Infants: The UmbiBaby Study. J Nutr 2023; 153:958-969. [PMID: 36775243 DOI: 10.1016/j.tjnut.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/09/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Placental insufficiency negatively impacts fetal growth and body composition (BC), potentially affecting lifelong health. Placental insufficiency, detectable as an abnormal umbilical artery resistance index (UmA-RI) on Doppler ultrasonography, is highly prevalent in otherwise healthy South African pregnant women. Appropriate intervention reduces stillbirth and perinatal death, but research on long-term outcomes of surviving infants is lacking. OBJECTIVES To describe and compare anthropometry and BC during the first 2 y of life in a cohort of term-born infants with normal and abnormal prenatal UmA-RI. METHODS Term-born infants (n = 81; n = 55 normal, n = 26 abnormal UmA-RI on third trimester Doppler screening) were followed up at 8-time points until age 2 y. Anthropometric measurements were taken, and FFM and FM were assessed by deuterium dilution. Age- and sex-specific z-scores were calculated for anthropometric indices, FM, FFM, FM index (FMI), and FFM index (FFMI) using appropriate reference data. Anthropometry and BC of infants with normal and abnormal UmA-RI were compared using an independent t-test or Mann-Whitney test. RESULTS At most ages, group mean z-scores were <0 for length-for-age and FM and >0 for weight-for-length and FFM. Compared with infants with normal UmA-RI, infants with abnormal UmA-RI had significantly lower weight-for-age z-scores at birth (-0.77 ± 0.75 compared with -0.30 ± 1.10, P = 0.026), ages 10 wk to 9 mo (-0.4 ± 0.87 to -0.2 ± 1.12 compared with 0.3 ± 0.85 to 0.6 ± 1.09; P = 0.007-0.017) and 18 mo (-0.6 ± 0.82 compared with 0.1 ± 1.18; P = 0.037); length-for-age z-scores at ages ≤14 wk (-1.3 ± 1.25 to -0.9 ± 0.87 compared with -0.2 ± 1.04 to -0.1 ± 1.00; P = 0.004-0.021); and FFM-for-age z-scores at ages ≤9 mo (-0.1 ± 0.82 to 0.7 ± 0.71 compared with 0.7 ± 1.00 to 1.3 ± 0.85; P = 0.002-0.028). FFMI, percentage FFM, FM, percentage FM, and FMI showed no consistent significant differences. CONCLUSIONS Infants with abnormal UmA-RI had lower weight-for-age and length-for-age z-scores, particularly at younger ages, with proportionally lower FFM but no consistent differences in percentage FFM and FFMI. These findings merit further investigation in larger cohorts. J Nutr 2023;xx:xx-xx.
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Affiliation(s)
- Sanja Nel
- Department of Human Nutrition, University of Pretoria, Pretoria, South Africa; Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa.
| | - Ute D Feucht
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa; Department of Paediatrics, University of Pretoria, Pretoria, South Africa; Gauteng Department of Health, Tshwane District Health Services, Pretoria, South Africa
| | - Helen Mulol
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa; Department of Paediatrics, University of Pretoria, Pretoria, South Africa; Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
| | - Friede Am Wenhold
- Department of Human Nutrition, University of Pretoria, Pretoria, South Africa; Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; South African Medical Research Council Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa
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10
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Couto EDO, Marano D, Amaral YNDVD, Moreira MEL. Predictive models of newborn body composition: a systematic review. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2020365. [PMID: 36921160 PMCID: PMC10014017 DOI: 10.1590/1984-0462/2023/41/2020365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/30/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To analyze the prediction models of fat-free mass and fat mass of neonates who had air displacement plethysmography as a reference test. DATA SOURCE A systematic review of studies identified in the PubMed, Virtual Health Library (BVS), SciELO, and ScienceDirect databases was carried out. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used for inclusion of studies, the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) report was used to select only predictive models studies, and the Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias in the models. DATA SYNTHESIS This study is registered in PROSPERO with identification CRD42020175048. Five hundred and three studies were found during the searches, and only four papers (six models) were eligible. Most studies (three) used the sum of different skinfolds to predict neonatal body fat and all presented weight as the variable with the highest contribution to predicting neonatal body composition. Two models that used skinfolds showed high coefficients of determination and explained, significantly, 81% of the body fat measured by air displacement plethysmography, while the models using bioimpedance did not find a significant correlation between the impedance index and the fat-free mass. CONCLUSIONS The few studies found on this topic had numerous methodological differences. However, the subscapular skinfold was a strong predictor of neonatal body fat in three studies. It is noteworthy that such model validation studies should be carried out in the future, allowing them to be subsequently applied to the population. The development of these models with low-cost tools will contribute to better nutritional monitoring of children and could prevent complications in adulthood.
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Affiliation(s)
- Elissa de Oliveira Couto
- Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Ferreira, Rio de Janeiro, RJ, Brazil
| | - Daniele Marano
- Instituto Nacional da Saúde da Mulher, da Criança e do Adolescente Fernandes Ferreira, Rio de Janeiro, RJ, Brazil
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Gopalakrishnamoorthy M, Whyte K, Horowitz M, Widen E, Toro-Ramos T, Johnson J, Gidwani S, Paley C, Rosenn B, Lin S, Thornton J, Pi-Sunyer X, Gallagher D. Anthropometric models to estimate fat mass at 3 days, 15 and 54 weeks. Pediatr Obes 2022; 17:e12855. [PMID: 34558804 PMCID: PMC8821135 DOI: 10.1111/ijpo.12855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Currently available infant body composition measurement methods are impractical for routine clinical use. The study developed anthropometric equations (AEs) to estimate fat mass (FM, kg) during the first year using air displacement plethysmography (PEA POD® Infant Body Composition System) and Infant quantitative magnetic resonance (Infant-QMR) as criterion methods. METHODS Multi-ethnic full-term infants (n = 191) were measured at 3 days, 15 and 54 weeks. Sex, race/ethnicity, gestational age, age (days), weight-kg (W), length-cm (L), head circumferences-cm (HC), skinfold thicknesses mm [triceps (TRI), thigh (THI), subscapular (SCP), and iliac (IL)], and FM by PEA POD® and Infant-QMR were collected. Stepwise linear regression determined the model that best predicted FM. RESULTS Weight, length, head circumference, and skinfolds of triceps, thigh, and subscapular, but not iliac, significantly predicted FM throughout infancy in both the Infant-QMR and PEA POD models. Sex had an interaction effect at 3 days and 15 weeks for both the models. The coefficient of determination [R2 ] and root mean square error were 0.87 (66 g) at 3 days, 0.92 (153 g) at 15 weeks, and 0.82 (278 g) at 54 weeks for the Infant-QMR models; 0.77 (80 g) at 3 days and 0.82 (195 g) at 15 weeks for the PEA POD models respectively. CONCLUSIONS Both PEA POD and Infant-QMR derived models predict FM using skinfolds, weight, head circumference, and length with acceptable R2 and residual patterns.
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Affiliation(s)
| | - Kathryn Whyte
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center
| | - Michelle Horowitz
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center
| | - Elizabeth Widen
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center,Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University,Department of Nutritional Sciences, The University of Texas at Austin
| | - Tatiana Toro-Ramos
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Jill Johnson
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Sonia Gidwani
- Department Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Charles Paley
- Department Pediatrics, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Barak Rosenn
- Department of Obstetrics and Gynecology, Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine
| | - Susan Lin
- Center for Family and Community Medicine, Columbia University
| | | | - Xavier Pi-Sunyer
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center,Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University
| | - Dympna Gallagher
- New York Nutrition Obesity Research Center, Division of Endocrinology, Department of Medicine, Columbia University Irving Medical Center,Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University
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Weight/length ratio references and newborn body composition estimation at birth from a Brazilian cohort. J Pediatr (Rio J) 2021; 97:610-616. [PMID: 33581117 PMCID: PMC9432055 DOI: 10.1016/j.jped.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The objective was to calculate weight/length (W/L) ratio values and percentiles by sex and gestational age (GA) to estimate fat mass (FM), fat-free mass (FFM) and body fat percentage (BF%) as well as to compare these indices in preterm, small (SGA), and large (LGA) for GA, stunted and wasted infants from a Brazilian cohort of newborns, comparing with the INTERGROWTH-21st. METHODS Secondary, cross-sectional analysis of data obtained of 7427 live-born infants from the BRISA Cohort Study in the city of Ribeirão Preto, SP, Brazil in 2010. For body composition estimation, W/L ratio was used in multiple regression models. The 3rd, 50th, and 97th percentiles for W/L ratio and body composition measures (FM, FFM, and BF%) were calculated using fractional polynomial regression models. RESULTS Average W/L ratio was 6.50 kg/m (SD 0.87), while for FM, BF%, and FFM the corresponding values were 359.64 g (145.76), 10.90% (3.05) and 2798.84 g (414.84), respectively. SGA (< 3rd percentile), and wasted infants showed the lowest W/L ratios and measures of body composition. The 3rd, 50th, and 97th percentiles charts of W/L, FM, BF%, and FFM by GA and sex are presented. CONCLUSIONS W/L ratio values of the RP-BRISA Cohort are higher than IG-21st. SGA (< 3rd) and wasted infants showed the lowest W/L ratio and measures of body composition. The body composition references presented here could be used to refine the nutritional assessment of Brazilian newborns and to facilitate comparisons across populations.
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Alja'nini Z, McNelis KM, Viswanathan S, Goddard GR, Merlino-Barr S, Collin M, Groh-Wargo S. Infant body composition assessment in the neonatal intensive care unit (NICU) using air displacement plethysmography: Strategies for implementation into clinical workflow. Clin Nutr ESPEN 2021; 43:212-222. [PMID: 34024517 DOI: 10.1016/j.clnesp.2021.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/03/2021] [Accepted: 04/10/2021] [Indexed: 11/19/2022]
Abstract
Nutritional management is integral to infant care in the neonatal intensive care unit (NICU). Recent research on body composition that specifically evaluated fat and fat-free mass has improved our understanding of infant growth and nutritional requirements. The need for body composition monitoring in infants is increasingly recognized as changes in fat mass and fat-free mass associated with early growth can impact clinical outcomes. With the availability of air displacement plethysmography (ADP) as a noninvasive method for assessing infant body composition and published normative gestational age- and sex-specific body composition curves, it is justifiable to integrate this innovation into routine clinical care. Here we describe our experiences in implementing body composition measurement using ADP in routine clinical care in different NICU settings.
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Affiliation(s)
- Zaineh Alja'nini
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA.
| | - Kera Michelle McNelis
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Perinatal Institute, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sreekanth Viswanathan
- Division of Neonatology, Department of Pediatrics, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Gillian R Goddard
- Division of Pediatric and General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Stephanie Merlino-Barr
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
| | - Marc Collin
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
| | - Sharon Groh-Wargo
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
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Wiechers C, Balles LS, Kirchhof S, Weber R, Avellina V, Pauluschke-Fröhlich J, Hallschmid M, Fritsche L, Preißl H, Fritsche A, Poets CF, Franz AR. Body composition in term offspring after maternal gestational diabetes does not predict postnatal hypoglycemia. BMC Pediatr 2021; 21:111. [PMID: 33676430 PMCID: PMC7936473 DOI: 10.1186/s12887-021-02578-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Offspring of mothers with gestational diabetes mellitus (GDM) have an increased risk of neonatal complications like birth trauma due to macrosomia or postnatal hypoglycemia, as well as long-term metabolic sequelae. Neonatal body composition may be a sensitive marker of metabolic effects on the fetus caused by suboptimal glycemic control during pregnancy. OBJECTIVE To determine body composition in offspring of mothers with GDM compared to a reference cohort of healthy term neonates and to assess whether increased body fat would be associated with postnatal hypoglycemia. METHODS This prospective, observational, cross-sectional study included 311 full-term, singleton infants born between June 2014 and July 2015. Body composition was measured within 96 h of birth using air displacement plethysmography. Results are indicated as median (1st Quartile - 3rd Quartile). RESULTS Of 311 infants, 40 (12.9%) were born to mothers with GDM. Birth weight standard deviation scores (SDS) (0.24 vs. - 0.07, p = 0.04), fat mass (370 g vs. 333 g, p = 0.02) as well as fat mass/total body mass (BF%; 11.4% vs. 10.8%, p = 0.03) were significantly higher in infants following maternal GDM than in controls. In GDM offspring, anthropometric parameters, fat mass or BF% did not differ between infants with or without postnatal hypoglycemia. In this cohort, SDS for birth weight, fat mass, fat free mass, BF% or postnatal hypoglycemia were not associated with maternal blood glucose levels measured at an oral glucose tolerance test. CONCLUSIONS SDS for birth weight, neonatal fat mass, and BF% were significantly higher in newborns following maternal GDM. In these infants born to mothers with GDM, body composition did not differ between those with or without postnatal hypoglycemia.
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Affiliation(s)
- Cornelia Wiechers
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany.
| | - Lena S Balles
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Sara Kirchhof
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Romy Weber
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Vanessa Avellina
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Jan Pauluschke-Fröhlich
- Department of Obstetrics and Gynecology, University Hospital, Eberhard Karls University, Calwerstraße 7, 72076, Tübingen, Germany
| | - Manfred Hallschmid
- Institute for Medical Psychology and Behavioural Neurobiology, Eberhard Karls University, Otfried-Müller-Straße 25, 72076, Tübingen, Germany.,German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany
| | - Louise Fritsche
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany
| | - Hubert Preißl
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany.,Department of Internal Medicine IV, Eberhard Karls University, Tuebingen, Germany
| | - Andreas Fritsche
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany.,Department of Internal Medicine IV, Eberhard Karls University, Tuebingen, Germany
| | - Christian F Poets
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Axel R Franz
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany.,Center for Pediatric Clinical Studies, University Children's Hospital, Eberhard Karls University, Tuebingen, Germany
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