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Am J Perinatol 2010; 27(9): 721-730
DOI: 10.1055/s-0030-1253555
© Thieme Medical Publishers

Small for Gestational Age and Higher Birth Weight Predict Childhood Obesity in Preterm Infants

Ronnesia B. Gaskins1 , Linda L. LaGasse1 , Jing Liu1 , Seetha Shankaran2 , Barry M. Lester1 , Henrietta S. Bada3 , Charles R. Bauer4 , Abhik Das5 , Rosemary D. Higgins6 , Mary Roberts1
  • 1Center for the Study of Children at Risk, Brown-Alpert Medical School, Women & Infants Hospital of Rhode Island, Providence, Rhode Island
  • 2Department of Pediatrics, Wayne State University, Detroit, Michigan
  • 3University of Kentucky, Lexington, Kentucky
  • 4University of Miami Leonard M. Miller School of Medicine, Miami, Florida
  • 5RTI International, Rockville, Maryland
  • 6Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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Publication Date:
20 April 2010 (online)

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ABSTRACT

We sought to determine the association between small for gestational age (SGA), birth weight, and childhood obesity within preterm polysubstance exposed children. We sampled 312 preterm children with 11-year body mass index (BMI; age- and sex-specific) data from the Maternal Lifestyle Study (51% girls, 21.5% SGA, 46% prenatal cocaine, and 55% tobacco exposed). Multinomial regression analyzed the association between 11-year obesity (OBE) and overweight (OW) and SGA, birth weight, first-year growth velocity, diet, and physical activity variables. Overall, 24% were OBE (BMI for age ≥95th percentile) and 16.7% were OW (BMI ≥85th and <95th percentiles). In adjusted analyses, SGA was associated with OW (odds ratio [OR] = 3.4, confidence interval [CI] 1.5 to 7.5). Higher birth weight was associated with OBE (OR = 1.8, CI 1.3 to 2.4) and OW (OR = 1.4, CI 1.1 to 2.0). Growth velocity was associated with OBE (OR = 2.7, CI 1.8 to 4.0) and OW (OR = 1.6, CI 1.1 to 2.4). Low exercise was associated with OBE (OR = 2.1, CI 1.0 to 4.4) and OW (OR = 2.1, CI 1.0 to 4.5). There was no effect of substance exposure on obesity outcomes. Many (41%) of these high-risk preterm 11-year-olds were obese/overweight. Multiple growth-related processes may be involved in obesity risk for preterm children, including fetal programming as indicated by the SGA effect.

KEYWORDS

Childhood obesity - premature birth - infant SGA - birth weight - exercise - prenatal drug exposure

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Ronnesia B GaskinsPh.D. M.S.P.H. 

Brown Center for the Study of Children at Risk, Brown-Alpert Medical School

Women & Infants Hospital of RI, 101 Dudley St., Providence, RI 02905

Email: Ronnesia_Gaskins@brown.edu