New charts for the assessment of body composition, according to air-displacement plethysmography, at birth and across the first 6 mo of life

ABSTRACT Background Air-displacement plethysmography (ADP) is a good candidate for monitoring body composition in newborns and young infants, but reference centile curves are lacking that allow for assessment at birth and across the first 6 mo of life. Objective Using pooled data from 4 studies, we aimed to produce new charts for assessment according to gestational age at birth (30 + 1 to 41 + 6 wk) and postnatal age at measurement (1–27 wk). Methods The sample comprised 222 preterm infants born in the United States who were measured at birth; 1029 term infants born in Ireland who were measured at birth; and 149 term infants born in the United States and 57 term infants born in Italy who were measured at birth, 1 and 2 wk, and 1, 2, 3, 4, 5, and 6 mo of age. Infants whose birth weights were <3rd or >97th centile of the INTERGROWTH-21st standard were excluded, thereby ensuring that the charts depict body composition of infants whose birth weights did not indicate suboptimal fetal growth. Sex-specific centiles for fat mass (kg), fat-free mass (kg), and percentage body fat were estimated using the lambda-mu-sigma (LMS) method. Results For each sex and measure (e.g., fat mass), the new charts comprised 2 panels. The first showed centiles according to gestational age, allowing term infants to be assessed at birth and preterm infants to be monitored until they reached term. The second showed centiles according to postnatal age, allowing all infants to be monitored to age 27 wk. The LMS values underlying the charts were presented, enabling researchers and clinicians to convert measurements to centiles and z scores. Conclusions The new charts provide a single tool for the assessment of body composition, according to ADP, in infants across the first 6 mo of life and will help enhance early-life nutritional management.

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Fat and Fat-Free Mass of Preterm and Term Infants from Birth to Six Months: A Review of Current Evidence

Nutrients ◽

10.3390/nu12020288 ◽

2020 ◽

Vol 12 (2) ◽

pp. 288 ◽

Cited By ~ 4

Author(s):

Constanze Hamatschek ◽

Efrah I. Yousuf ◽

Lea Sophie Möllers ◽

Hon Yiu So ◽

Katherine M. Morrison ◽

...

Keyword(s):

Preterm Infants ◽

Fat Mass ◽

Infant Nutrition ◽

Dual Energy ◽

Fat Free Mass ◽

Current Evidence ◽

Term Infants ◽

Air Displacement Plethysmography ◽

X Ray ◽

Postmenstrual Age

To optimize infant nutrition, the nature of weight gain must be analyzed. This study aims to review publications and develop growth charts for fat and fat-free mass for preterm and term infants. Body composition data measured by air displacement plethysmography (ADP) and dual energy X-ray absorptiometry (DXA) in preterm and term infants until six months corrected age were abstracted from publications (31 December 1990 to 30 April 2019). Age-specific percentiles were calculated. ADP measurements were used in 110 studies (2855 preterm and 22,410 term infants), and DXA was used in 28 studies (1147 preterm and 3542 term infants). At term age, preterm infants had higher percent-fat than term-born infants (16% vs. 11%, p < 0.001). At 52 weeks postmenstrual age (PMA), both reached similar percent-fat (24% vs. 25%). In contrast, at term age, preterm infants had less fat-free mass (2500 g vs. 2900 g) by 400 g. This difference decreased to 250 g by 52 weeks, and to 100 g at 60 weeks PMA (5000 g vs. 5100 g). DXA fat-free mass data were comparable with ADP. However, median percent-fat was up to 5% higher with DXA measurements compared with ADP with PMA > 50 weeks. There are methodological differences between ADP and DXA measures for infants with higher fat mass. The cause of higher fat mass in preterm infants at term age needs further investigation.

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Body composition during the first 4 months in infants affected by neonatal abstinence syndrome: a pilot study

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174421000052 ◽

2021 ◽

pp. 1-8

Author(s):

Tammy E. Corr ◽

Eric W. Schaefer ◽

Ian M. Paul

Keyword(s):

Body Composition ◽

Fat Mass ◽

Gestational Age ◽

Symptom Control ◽

Fat Free Mass ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Term Infants ◽

Feeding Difficulties ◽

Composition Measurements

Abstract Newborns with neonatal abstinence syndrome (NAS) display symptoms related to neurologic excitability and autonomic dysfunction that result in increased metabolic demands. These infants also exhibit feeding difficulties and/or hyperphagia. Because the effects of these symptoms and behaviors on growth are unknown, we sought to measure serial body composition measurements over the first 4 months in infants with NAS requiring pharmacologic treatment using air displacement plethysmography. Fourteen infants of singleton birth with appropriate-for-gestational-age (AGA) weight and a gestational age of ≥35 weeks and <42 weeks were evaluated. In mixed-effects models, per week, infants increased in mean fat percent by 1.1% (95% confidence interval [CI]: 0.85–1.43), fat mass by 90 g (CI: 70–100), and fat-free mass by 140 g (CI: 130–150). The subgroup of infants (N = 5) requiring multidrug therapy for symptom control had lower mean fat percent (−1.2%, CI: −5.2–2.1), fat mass (−60 g, CI: −25–13), and fat-free mass (−270 g, CI: −610–80) across time compared to infants requiring monotherapy. We are the first to report how body composition measures change over time in a small group of patients with NAS. Infants with NAS were smaller and leaner in the first several weeks compared to previously reported body composition measurements in term infants, but grew similarly to their healthy counterparts by 16 weeks. Infants with more severe NAS may be at risk for abnormalities in longer term growth.

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Body composition in preterm infants with intrauterine growth restriction: a cohort study

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0175 ◽

2018 ◽

Vol 46 (7) ◽

pp. 804-810 ◽

Cited By ~ 1

Author(s):

Letícia Duarte Villela ◽

Maria Dalva Barbosa Baker Méio ◽

Saint Clair S. Gomes Junior ◽

Andrea Dunshee de Abranches ◽

Fernanda Valente Mendes Soares ◽

...

Keyword(s):

Body Composition ◽

Cohort Study ◽

Preterm Infants ◽

Fat Mass ◽

Lean Mass ◽

Gestational Age ◽

Growth Patterns ◽

Very Preterm Infants ◽

Air Displacement Plethysmography ◽

Appropriate For Gestational Age

Abstract Aims: The comparison of body composition parameters between the small for gestational age (SGA) and appropriate for gestational age (AGA) at term, 1, 3 and 5 months corrected ages in very preterm infants. Methods: This cohort study included 92 preterm infants at term age, younger than 32 weeks or <1500 g, classified in two groups: SGA and AGA. Anthropometry and body composition, estimated by air displacement plethysmography, were evaluated at the corrected ages: term and 1, 3, and 5 months. We used the lean mass/fat mass index (LM/FM) at each time point and the weight, length and head circumference SDS gain between the time points. Results: At term age, the SGA preterm infants had less lean mass (g), fat mass (g) and percent fat mass but a greater LM/FM index than AGA infants (P<0.001). At 1 month corrected age the LM/FM index and percent fat mass between the groups became similar. Lower lean mass persisted up to 3 months in the SGA group [4004 g (3256–4595) vs. 4432 g (3190–6246), P<0.001]. During the first month corrected age, the weight SDS gain was higher in SGA preterm infants when compared to AGA preterm infants. However, the SGA preterm infants remained lighter, shorter and with smaller head circumferences than the AGA preterm infants until 3 months of corrected age. Conclusions: The greater lean tissue deficits and an earlier “catch-up” in fat in the SGA group can reflect growth patterns variability since the early life.

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Seasonal and Longitudinal Changes in Body Composition by Sport-Position in NCAA Division I Basketball Athletes

Sports ◽

10.3390/sports6030085 ◽

2018 ◽

Vol 6 (3) ◽

pp. 85 ◽

Cited By ~ 5

Author(s):

Jennifer Fields ◽

Justin Merrigan ◽

Jason White ◽

Margaret Jones

Keyword(s):

Body Composition ◽

Body Mass ◽

Body Fat ◽

Fat Mass ◽

Ncaa Division I ◽

The Body ◽

Fat Free Mass ◽

Strength And Conditioning ◽

Air Displacement Plethysmography ◽

Within Subjects

The purpose of this study was to assess the body composition of male and female basketball athletes (n = 323) across season, year, and sport-position using air displacement plethysmography. An independent sample t-test assessed sport-position differences. An analysis of variance was used to assess within-subjects across season (pre-season, in-season, and off-season), and academic year (freshman, sophomore, and junior). For both men and women basketball (MBB, WBB) athletes, guards had the lowest body fat, fat mass, fat free mass, and body mass. No seasonal differences were observed in MBB, but following in-season play for WBB, a reduction of (p = 0.03) in fat free mass (FFM) was observed. Across years, MBB showed an increase in FFM from freshman to sophomore year, yet remained unchanged through junior year. For WBB across years, no differences occurred for body mass (BM), body fat (BF%), and fat mass (FM), yet FFM increased from sophomore to junior year (p = 0.009). Sport-position differences exist in MBB and WBB: Guards were found to be smaller and leaner than forwards. Due to the importance of body composition (BC) on athletic performance, along with seasonal and longitudinal shifts in BC, strength and conditioning practitioners should periodically assess athletes BC to ensure preservation of FFM. Training and nutrition programming can then be adjusted in response to changes in BC.

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Receipt of Breast Milk by Gestational Age – United States, 2017 (P11-060-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-060-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Katelyn Chiang ◽

Andrea Sharma ◽

Jennifer Nelson ◽

Christine Olson ◽

Cria Perrine

Keyword(s):

United States ◽

Breast Milk ◽

Gestational Age ◽

Infant Nutrition ◽

Birth Certificate ◽

The United States ◽

Late Preterm ◽

Term Infants ◽

Oak Ridge ◽

Extremely Preterm

Abstract Objectives Breast milk is the optimal source of infant nutrition. For the nearly 1 in 10 infants born prematurely in the United States annually, breast milk is especially beneficial, helping prevent sepsis and necrotizing enterocolitis (NEC) and promoting neurological development. Though the importance of breast milk for preterm infants has been established, national estimates of feeding practices by gestational age are unavailable. Our objective was to describe receipt of breast milk among preterm and term infants delivered in the United States in 2017. Methods Birth certificate data from 48 states and the District of Columbia (n = 3,194,873; 82.7% of all births) were analyzed to describe receipt of breast milk before birth certificate completion among extremely preterm (20-27 weeks), early preterm (28-33 weeks), late preterm (34-36 weeks) and term infants (≥ 37 weeks) with further stratification by maternal and infant characteristics. Results The prevalence of infants receiving breast milk was 83.9% overall and varied by gestational age: 71.3% (extremely preterm), 76.0% (early preterm), 77.3% (late preterm), and 84.6% (term). Disparities in receipt of breast milk by maternal race/ethnicity were noted across gestational ages. Infants delivered to black or American Indian/Alaska Native mothers were the least likely to have received breast milk while those delivered to white, Hispanic, and Asian mothers were more likely to have received breast milk. Differences in receipt of breast milk by other maternal sociodemographic factors also persisted similarly across gestational ages. Among late preterm and term infants, receipt of breast milk was lower for those admitted to the neonatal intensive care unit (NICU) than those not admitted to the NICU. Conclusions Fewer preterm than term infants received breast milk in the first few days of life. Optimal hospital policies and practices that support breast milk feeding and ensure availability of donor milk for high-risk infants may help improve infant nutrition and reduce infant morbidity and mortality. Mothers of infants admitted to the NICU may need additional support given the challenges associated with having a medically fragile infant such as mother-infant separation and extended infant hospitalization. Funding Sources Centers for Disease Control and Prevention, Oak Ridge Institute for Science and Education.

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Body composition among long distance runners

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.2.180 ◽

2020 ◽

Vol 66 (2) ◽

pp. 180-186

Author(s):

Joana Rosado ◽

João P. Duarte ◽

Paulo Sousa-e-Silva ◽

Daniela C. Costa ◽

Diogo V. Martinho ◽

...

Keyword(s):

Body Composition ◽

Fat Mass ◽

Adult Male ◽

Bioelectrical Impedance ◽

The Body ◽

Fat Free Mass ◽

Body Density ◽

Distance Runners ◽

Long Distance ◽

Air Displacement Plethysmography

SUMMARY OBJECTIVE The current study aimed to examine the body composition of adult male ultra-trail runners (UTR) according to their level of participation (regional UTR-R, vs. national UTR-N). METHODS The sample was composed of 44 adult male UTR (aged 36.5±7.2 years; UTR-R: n=25; UTR-N: n=19). Body composition was assessed by air displacement plethysmography, bioelectrical impedance, and dual-energy X-ray absorptiometry. In addition, the Food Frequency Questionnaire (FFQ) was applied. A comparison between the groups was performed using independent samples t-test. RESULTS Significant differences between groups contrasting in the competitive level were found for chronological age (in years; UTR-R: 38.8±8.2 vs. UTR-N: 33.5±4.1); body density (in L.kg-1; UTR-R: 1.062±0.015 vs. UTR-N: 1.074±0.009); and fat mass (in kg; UTR-R: 12.7±6.8 vs. UTR-N: 7.6±2.7). CONCLUSION UTR-N were younger, presented higher values for body density, and had less fat mass, although no significant differences were found for fat-free mass. The current study evidenced the profile of long-distance runners and the need for weight management programs to regulate body composition.

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Cord blood leptin and gains in body weight and fat mass during infancy

Acta Endocrinologica ◽

10.1530/eje-16-0431 ◽

2016 ◽

Vol 175 (5) ◽

pp. 403-410 ◽

Cited By ~ 16

Author(s):

Carol ní Chaoimh ◽

Deirdre M Murray ◽

Louise C Kenny ◽

Alan D Irvine ◽

Jonathan O’B Hourihane ◽

...

Keyword(s):

Body Composition ◽

Weight Gain ◽

Cord Blood ◽

Fat Mass ◽

Early Life ◽

Fat Free Mass ◽

Birth Cohort Study ◽

Fat Mass Index ◽

Air Displacement Plethysmography ◽

Design And Methods

Objectives Low early-life leptin concentrations may promote faster weight gain in infancy. We aimed to examine the associations between cord blood leptin concentrations and changes in weight and body composition during infancy. Design and methods Serum leptin was measured at 15 weeks gestation, in umbilical cord blood collected at delivery and at 2 years in 334 children from the Cork Baseline Birth Cohort Study. Body composition was measured at 2 days and 2 months using air displacement plethysmography. Conditional change in weight standard deviation scores over a number of age intervals in the first 2 years and conditional change in fat mass index (FMI) and fat-free mass index (FFMI) (kg/(length)m2) between birth and 2 months were calculated and associations with cord blood leptin were examined using linear regression. Results At birth, cord blood leptin was positively correlated with FMI (r = 0.48, P < 0.001) and showed a weaker correlation with FFMI (r = 0.12, P = 0.05). After adjustment for confounders, higher cord blood leptin (per ng/mL) was associated with slower conditional weight gain between birth and 2 months (β (95% CI): −0.024 (−0.035, −0.013), P < 0.001) but not over subsequent age intervals. Cord blood leptin was also inversely associated with conditional change in FMI (−0.021 (−0.034, −0.007, P = 0.003) but not FFMI between birth and 2 months. Conclusions These are the first data to show that associations between higher cord blood leptin and slower weight gain during infancy are driven by lower increases in adiposity, at least in early infancy.

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737. The Prevalence of Diagnosed Chronic Lung Disease in US Infants by Gestational Age: Implications for RSV Policy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.744 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S264-S265 ◽

Cited By ~ 1

Author(s):

Christopher S Ambrose ◽

Xiaohui Jiang ◽

Kunjana Mavunda

Keyword(s):

United States ◽

Lung Disease ◽

Gestational Age ◽

Chronic Lung Disease ◽

The United States ◽

Supplemental Oxygen ◽

High Risk Group ◽

Term Infants ◽

Postmenstrual Age ◽

Nationally Representative

Abstract Background Perinatal chronic lung disease (CLD), previously referred to as bronchopulmonary dysplasia (BPD), is associated with preterm birth and occurs rarely among term infants. Children with CLD are at elevated risk for severe RSV disease in the first 2 years of life. Definitions of CLD/BPD identify infants who require supplemental oxygen at 28 days of life or 36 weeks postmenstrual age, with no restriction by gestational age (GA) at birth. However, the AAP Committee on Infectious Disease guidance does not recommend RSV immunoprophylaxis for infants with CLD born at ≥32 weeks gestational age (wGA), even though infants with CLD/BPD up to 41 wGA were included in pivotal efficacy studies. This study determined the prevalence of diagnosed CLD in US infants as a function of wGA at birth and the number of infants with CLD born at ≥32 wGA. Methods The Kids’ Inpatient Database (KID) is a nationally representative survey conducted every 3 years in the United States. Birth hospitalization data from KID were utilized to estimate the prevalence of CLD (ICD-9 = 770.7) among US infants in 2003–2012 overall and as a function of coincident codes for GA (ICD-9 = 765.21–765.29, reported in 2-week intervals). The prevalence of CLD among 32 wGA infants was imputed based on the distribution of CLD cases as a function of wGA. KID data from 2015 were not available due to the transition to ICD-10 coding. Results A total of 31,984 infants had a CLD diagnosis across the 4 years, representing 0.2% of US births. The prevalence of CLD declined from 20.8 to 19.5 per 10,000 between 2003 and 2012. Of those, 25,554 infants with CLD (80%) had GA coded in the database. The percentage of CLD infants born at <27 wGA increased from 44% in 2003 to 52% in 2012, whereas the percentage at ≥29 wGA decreased from 27% to 21% (figure). Overall, the percentages born at 31–32, 33–34, and >34 wGA were 5.7%, 2.2%, and 1.2%, respectively. An estimated 5.7% of infants with CLD were born at ≥32 wGA, representing 0.9 of every 10,000 US births or ~350 infants annually. Conclusion Fewer than 400 infants are born at ≥32 wGA and diagnosed with CLD annually in the United States. The rationale for excluding this small but high-risk group of infants from the population recommended for RSV immunoprophylaxis is not clear. Funded by AstraZeneca :Disclosures. C. S. Ambrose, AstraZeneca: Employee, Salary and Stocks. X. Jiang, EpiStat Institute: Employee, Consulting fee and Salary. AstraZeneca: Consultant, Consulting fee. K. Mavunda, AstraZeneca: Speaker’s Bureau, Speaker honorarium.

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Associations of Measured Protein and Energy Intakes with Growth and Adiposity in Human Milk-Fed Preterm Infants at Term Postmenstrual Age: A Cohort Study

American Journal of Perinatology ◽

10.1055/s-0038-1626717 ◽

2018 ◽

Vol 35 (09) ◽

pp. 882-891 ◽

Cited By ~ 4

Author(s):

Luis Pereira-da-Silva ◽

Manuela Cardoso ◽

Israel Macedo

Keyword(s):

Body Composition ◽

Weight Gain ◽

Human Milk ◽

Preterm Infants ◽

Fat Mass ◽

Lower Energy ◽

Nutrient Intakes ◽

Air Displacement Plethysmography ◽

Protein Energy ◽

Postmenstrual Age

Objective To determine the associations of measured protein, energy, and protein-to-energy (PER) intakes with body composition in human milk (HM)-fed preterm infants. Study Design Neonates born at < 33 gestational weeks were eligible. Standard fortification method with modular supplements was used and the HM composition was measured. The weight gain velocity was calculated, and body composition was assessed by air displacement plethysmography at 40 weeks' postmenstrual age (PMA). The fat mass percentage and fat mass index were used as indicators of adiposity, with convenience cut-offs ≤ –1 and ≥ + 1 z-scores for low and high adiposity, respectively. Results Thirty-three infants were included (median [interquartile range] gestational age: 30 [28–31] weeks; birth weight: 1.175 [1.010–1.408] g); 36.4 and 84.8% did not receive the minimum recommended protein and energy intakes, respectively. Weight gain velocity showed positive weak-to-moderate correlations with nutrient intakes. Overall, no correlations between nutrient intakes and body composition were found. Infants with lower adiposity received lower energy, protein, and PER intakes, while those with higher adiposity received lower energy intake but higher PER intake. Conclusion Overall, no correlations of nutrient intakes with body composition were found; however, differences in nutrient intakes were found between infants with lower and higher adiposity at term PMA.

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Respiratory Syncytial Virus Disease: Immunoprophylaxis Policy Review and Public Health Concerns in Preterm and Young Infants

Policy Politics & Nursing Practice ◽

10.1177/1527154420965543 ◽

2020 ◽

pp. 152715442096554

Author(s):

Suzanne Staebler ◽

Stephanie Blake

Keyword(s):

United States ◽

Health Care ◽

Respiratory Syncytial Virus ◽

High Risk ◽

Specific Treatment ◽

The United States ◽

Full Term ◽

Term Infants ◽

Young Infants ◽

Syncytial Virus

Globally, respiratory syncytial virus (RSV) is a leading cause of hospitalization due to severe respiratory infections in infants of all gestational ages and children aged 5 years and younger, and it is associated with a substantial health care burden. Approximately, 1% to 3% of infants younger than 1 year are hospitalized with severe RSV disease in the United States. With no specific treatment or vaccine, palivizumab is the only licensed immunoprophylaxis for the prevention of severe RSV disease in high-risk pediatric populations, including infants born at or before 35 weeks’ gestational age (wGA). In the United States, the American Academy of Pediatrics (AAP) periodically publishes its recommendation for the use of RSV immunoprophylaxis, which is largely followed by health care professionals and payers. In 2014, the AAP Committee on Infectious Diseases stopped recommending RSV immunoprophylaxis for otherwise healthy infants born at or after 29 wGA and stated that the RSV hospitalization rates in infants 29 to 34 wGA and full-term infants were similar. Several studies have demonstrated that a significant decline in palivizumab use following the AAP 2014 recommendations was accompanied by increases in rates of RSV hospitalization and disease severity and hospital costs in infants 29 to 34 wGA versus full-term infants. Despite the growing evidence demonstrating high RSV morbidity in infants 29 to 34 wGA, the AAP reaffirmed its 2014 policy in 2019. This article will discuss the critical roles and strategies of advocacy groups and nurses in providing the maximum protection with RSV immunoprophylaxis to all high-risk and label-eligible preterm infants.

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