Persistence of underweight status among late preterm infants.

Neera K Goyal, Alexander G Fiks, Scott A Lorch
Author Information
  1. Neera K Goyal: Division of Neonatology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. neera.goyal@cchmc.org

Abstract

OBJECTIVE: To determine the association of late preterm gestation (34-36 weeks' gestation) with underweight status in infancy.
DESIGN: Retrospective cohort study.
SETTING: Thirty-one primary care sites within a hospital-owned network, from January 1, 2007, through June 30, 2009.
PARTICIPANTS: Seven thousand eight hundred sixty-six infants with gestational ages ranging from 34 to 42 weeks, followed up through the first 18 months of life. Analytic sample consisted of 7624 infants examined at 6 months of age; 7132, at 1 year; and 6957, at 18 months.
MAIN EXPOSURE: Late preterm (34-36 weeks), early term (37-38 weeks), or full-term (39-42 weeks) gestation.
MAIN OUTCOME MEASURES: Weight-for-age z score of 2 or less at 6, 12, and 18 months.
RESULTS: Compared with full-term gestation, late preterm gestation was associated with increased adjusted odds ratios (AORs) of weight-for-age z score of 2 or less at 6 months (AOR, 3.48 [95% CI, 2.17-5.72]) and 12 months (2.22 [1.07-4.61]). At 18 months, this association was not significant (AOR, 1.62 [95% CI, 0.69-3.84]). After exclusion of infants who were small for their gestational age, late prematurity was associated with underweight status when defined as a decline from birth weight of more than the 10th percentile to a weight-for-age z score of 2 or less at 6 months (AOR, 3.35 [95% CI, 1.76-6.38]) and 12 months (2.72 [1.02-7.27]) but not 18 months (1.88 [0.64-5.55]).
CONCLUSIONS: There is an association between late prematurity and underweight status in the first year of life. Further research is needed to determine the effect of this growth pattern on developmental outcomes and to optimize nutritional management.

References

  1. Int J Epidemiol. 2004 Aug;33(4):839-47 [PMID: 15155703]
  2. Acad Emerg Med. 2010 Feb;17(2):204-13 [PMID: 20370751]
  3. J Perinatol. 2012 Feb;32(2):91-6 [PMID: 21660083]
  4. Acta Paediatr. 1992 Apr;81(4):311-4 [PMID: 1606390]
  5. Semin Perinatol. 2006 Apr;30(2):61-8 [PMID: 16731278]
  6. Ann Hum Biol. 2003 Sep-Oct;30(5):499-519 [PMID: 12959893]
  7. Pediatrics. 2010 Dec;126(6):1124-31 [PMID: 21098151]
  8. Clin Pediatr (Phila). 2006 Jan-Feb;45(1):1-6 [PMID: 16429209]
  9. Paediatr Perinat Epidemiol. 2010 Jul 1;24(4):370-82 [PMID: 20618727]
  10. Pediatrics. 2011 Jun;127(6):1111-24 [PMID: 21624885]
  11. Am J Obstet Gynecol. 2011 Mar;204(3):263.e1-4 [PMID: 21236401]
  12. Obstet Gynecol. 1996 Feb;87(2):163-8 [PMID: 8559516]
  13. J Pediatr. 2008 Jul;153(1):25-31 [PMID: 18571530]
  14. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F208-14 [PMID: 10794788]
  15. Arch Dis Child. 2007 Feb;92(2):115-9 [PMID: 16905563]
  16. Pediatrics. 2009 Apr;123(4):e622-9 [PMID: 19336353]
  17. J Pediatr. 2009 Feb;154(2):169-76 [PMID: 19081113]
  18. Pediatrics. 2009 Feb;123(2):653-9 [PMID: 19171634]
  19. Early Hum Dev. 2011 Apr;87(4):321-3 [PMID: 21316877]
  20. Pediatrics. 1993 May;91(5):941-8 [PMID: 8474814]
  21. Pediatrics. 2004 Sep;114(3):e327-32 [PMID: 15342893]
  22. Pediatrics. 2011 Oct;128(4):e830-8 [PMID: 21911345]
  23. Epidemiology. 2009 Jul;20(4):488-95 [PMID: 19525685]
  24. J Pediatr. 1994 Dec;125(6 Pt 2):S103-9 [PMID: 7983564]
  25. Pediatrics. 2006 Apr;117(4):1262-9 [PMID: 16585323]
  26. Pediatrics. 2010 Aug;126(2):e311-9 [PMID: 20603259]
  27. BMJ. 2000 Apr 8;320(7240):967-71 [PMID: 10753147]
  28. Obstet Gynecol Int. 2010;2010:231842 [PMID: 20339531]
  29. NCHS Data Brief. 2009 Nov;(24):1-8 [PMID: 19922725]
  30. J Pediatr. 2007 Nov;151(5):450-6, 456.e1 [PMID: 17961684]
  31. Am J Epidemiol. 2002 Sep 1;156(5):471-82 [PMID: 12196317]
  32. BMC Pediatr. 2009 Nov 16;9:71 [PMID: 19917121]
  33. Arch Dis Child. 2004 Aug;89(8):728-33 [PMID: 15269070]
  34. Natl Vital Stat Rep. 2010 Dec 8;59(1):1, 3-71 [PMID: 22145497]
  35. J Child Psychol Psychiatry. 2004 Mar;45(3):641-54 [PMID: 15055382]
  36. Pediatrics. 2004 Aug;114(2):372-6 [PMID: 15286219]
  37. Pediatr Res. 1995 Aug;38(2):267-71 [PMID: 7478827]
  38. Pediatrics. 1998 Dec;102(6):E67 [PMID: 9832595]
  39. MMWR Recomm Rep. 2010 Sep 10;59(RR-9):1-15 [PMID: 20829749]
  40. JAMA. 2010 Jul 28;304(4):419-25 [PMID: 20664042]
  41. Int J Epidemiol. 2011 Oct;40(5):1215-26 [PMID: 21764769]
  42. Semin Perinatol. 2003 Aug;27(4):302-10 [PMID: 14510321]
  43. Arch Dis Child Fetal Neonatal Ed. 2011 Sep;96(5):F348-54 [PMID: 21242241]
  44. Pediatrics. 2009 Jan;123(1):109-13 [PMID: 19117868]
  45. Pediatrics. 1995 Aug;96(2 Pt 1):373-4 [PMID: 7630705]
  46. Stat Med. 1991 Apr;10(4):585-98 [PMID: 2057657]
  47. J Child Psychol Psychiatry. 2003 Jul;44(5):743-51 [PMID: 12831118]
  48. J Pediatr Gastroenterol Nutr. 1993 Jul;17(1):66-71 [PMID: 8350213]
  49. Semin Perinatol. 2006 Feb;30(1):8-15 [PMID: 16549207]
  50. Arch Dis Child. 2005 Feb;90(2):125-31 [PMID: 15665162]
  51. Early Hum Dev. 2011 Jul;87(7):495-507 [PMID: 21550187]
  52. Semin Perinatol. 2006 Apr;30(2):54-60 [PMID: 16731277]
  53. Arch Dis Child. 2003 Jun;88(6):482-7 [PMID: 12765911]
  54. Pediatrics. 2007 Mar;119(3):e659-65 [PMID: 17332185]
  55. Pediatrics. 2009 Jun;123(6):e1072-7 [PMID: 19482740]
  56. JAMA. 2000 Aug 16;284(7):843-9 [PMID: 10938173]

Grants

  1. K23 HD059919/NICHD NIH HHS
  2. R01 HD057168/NICHD NIH HHS

MeSH Term

Cohort Studies
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Pregnancy
Premature Birth
Retrospective Studies
Thinness

Word Cloud

Created with Highcharts 10.0.0months2lategestation118pretermunderweightstatusinfantsweeks6associationzscoreless12AOR[95%CIdetermine34-36gestationalfirstlifeageyearMAINfull-termassociatedweight-for-age3[1prematurityOBJECTIVE:weeks'infancyDESIGN:RetrospectivecohortstudySETTING:Thirty-oneprimarycaresiteswithinhospital-ownednetworkJanuary2007June302009PARTICIPANTS:Seventhousandeighthundredsixty-sixagesranging3442followedAnalyticsampleconsisted7624examined71326957EXPOSURE:Lateearlyterm37-3839-42OUTCOMEMEASURES:Weight-for-ageRESULTS:ComparedincreasedadjustedoddsratiosAORs4817-572]2207-461]significant62069-384]exclusionsmalldefineddeclinebirthweight10thpercentile3576-638]7202-727]88[064-555]CONCLUSIONS:researchneededeffectgrowthpatterndevelopmentaloutcomesoptimizenutritionalmanagementPersistenceamong

Similar Articles

Cited By