551: Does high prepregnancy body mass index (BMI) mask increased risk for small-for-gestational-age (SGA) birthweight and associated perinatal mortality?

The aim of the study was to evaluate growth pattern of small- and appropriate-for-gestationalage children and to identify prenatal and postnatal risk factors for short stature and development of components of metabolic syndrome. A total of 109 small- and 239 appropriate-for-gestational-age infants were enrolled in the study. Within 24 hours after birth and at 2, 5, 9, 12, 18, 24 months, and 6 years of age, anthropometric data were recorded for study children. Cord blood samples from study infants were collected, and insulin-like growth factor-1 (IGF), IGF-binding protein-3, and leptin levels were measured. Birth weight and height (P<0.001) and insulin-like growth factor-1, IGF-binding protein-3, and leptin levels (P<0.05) were lower in children born small for gestational age vs. children born appropriate for gestational age. At 2, 5, 12, 18, and 24 months and 6 years of age, children born small for gestational age remained shorter and weighed less (P<0.001). Waist-to-hip ratio, heart rate at 6 years of age and gain in body mass index from birth up to 6 years of age was higher in children born small for gestational age. Height gain during the first year of life was mainly influenced by birth length and target height. Maternal weight before pregnancy and cord leptin levels were the most significant factors influencing postnatal weight gain during the first years of life. Conclusions. During the first 6 years of life, children born small for gestational age remained shorter and lighter. A greater catch-up in body mass index and tendency towards central pattern of fat distribution during the first years of life might be predisposing factors for the development of long-term metabolic complications in these individuals.

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Changes in prepregnancy body mass index between the first and second pregnancies and risk of large-for-gestational-age birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.12.036 ◽

2007 ◽

Vol 196 (6) ◽

pp. 530.e1-530.e8 ◽

Cited By ~ 41

Author(s):

Darios Getahun ◽

Cande V. Ananth ◽

Morgan R. Peltier ◽

Hamisu M. Salihu ◽

William E. Scorza

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Gestational Age ◽

Large For Gestational Age ◽

Prepregnancy Body Mass Index

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Longitudinal Changes in Insulin-Like Growth Factor-I, Insulin Sensitivity, and Secretion from Birth to Age Three Years in Small-for-Gestational-Age Children

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2006-0844 ◽

2006 ◽

Vol 91 (11) ◽

pp. 4645-4649 ◽

Cited By ~ 68

Author(s):

Germán Iñiguez ◽

Ken Ong ◽

Rodrigo Bazaes ◽

Alejandra Avila ◽

Teresa Salazar ◽

...

Keyword(s):

Body Mass Index ◽

Insulin Secretion ◽

Birth Weight ◽

Body Mass ◽

Gestational Age ◽

Small For Gestational Age ◽

Cell Function ◽

Model Assessment ◽

Igf I ◽

Catch Up

Abstract Introduction: Insulin resistance (IR) develops as early as age 1 to 3 yr in small for gestational age (SGA) infants who show rapid catch-up postnatal weight gain. In contrast, greater insulin secretion is related to infancy height gains. We hypothesized that IGF-I levels could be differentially related to gains in length and weight and also differentially related to IR and insulin secretion. Methods: In a prospective study of 50 SGA (birth weight < 5th percentile) and 14 normal birth weight [appropriate for gestational age (AGA)] newborns, we measured serum IGF-I levels at birth, 1 yr, and 3 yr. IR (by homeostasis model assessment) and insulin secretion (by short iv glucose tolerance test) were also measured at 1 yr and 3 yr. Results: SGA infants had similar mean length and weight at 3 yr compared with AGA infants. SGA infants had lower IGF-I levels at birth (P < 0.0001), but conversely they had higher IGF-I levels at 3 yr (P = 0.003) than AGA infants. Within the SGA group, at 1 yr IGF-I was associated with length gain from birth and insulin secretion (P < 0.0001); in contrast at 3 yr IGF-I was positively related to weight, body mass index, and IR. Conclusions: IGF-I levels increased rapidly from birth in SGA, but not AGA children. During the key first-year growth period, IGF-I levels were related to β-cell function and longitudinal growth. In contrast, by 3 yr, when catch-up growth was completed, IGF-I levels were related to body mass index and IR, and these higher IGF-I levels in SGA infants might indicate the presence of relative IGF-I resistance.

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