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VOLUME 1 , ISSUE 1 ( January-March, 2022 ) > List of Articles

ORIGINAL RESEARCH

Accretion Rates of Fat and Fat-free Mass in Infants at 30–45 weeks’ Postmenstrual Age

Sreekanth Viswanathan, Kera M McNelis, Akhil Maheshwari, Zaineh Aja'Nini, Stephanie Merlino, Marissa Culver, Marc Collin, Darlene Calhoun, Sharon Grow-Wargo

Keywords : Body composition, Postnatal growth, Preterm infants

Citation Information : Viswanathan S, McNelis KM, Maheshwari A, Aja'Nini Z, Merlino S, Culver M, Collin M, Calhoun D, Grow-Wargo S. Accretion Rates of Fat and Fat-free Mass in Infants at 30–45 weeks’ Postmenstrual Age. 2022; 1 (1):7-13.

DOI: 10.5005/jp-journals-11002-0018

License: CC BY-NC 4.0

Published Online: 31-03-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background: Body composition assessment using noninvasive air displacement plethysmography (ADP) can help determine the quality of postnatal growth in infants. The accretion rates of fat mass (FM) and fat-free mass (FFM), both are known to change in various clinicopathological situations in a discordant fashion, can also help evaluate the short-term impacts of nutritional interventions on body composition. Objectives: To determine the FM and FFM accretion rates from 30 to 45 weeks’ postmenstrual age (PMA) and whether these rates are different between male and female infants. Methods: We used previously published normative data with median FM and FFM values for infants at 30–45 weeks’ PMA (Norris et al., 2019). Weekly gains in FM and FFM in g/week and g/kg/week were calculated using early one-point and average two-point methods. Results: FM and FFM accretion rates calculated by the early one-point method were higher than the average two-point method. Male and female infants had similar FM and FFM accretion rates. Constant accretion rates of FM and FFM were not aligned with individual weekly accretion rates, which showed a twofold–fourfold change. A composite index (FFM/FM accretion rate ratio), which we named the “body composition accretion ratio” (BCAR), was more sensitive than the individual weekly accretion rates and showed a ninefold change during the study period. Conclusions: Weekly FM and FFM accretion rates can help assess quality of postnatal growth in young infants, but BCAR can be a more useful, sensitive index for early identification of body composition changes and may possibly guide nutritional interventions.


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  1. Ong KK, Kennedy K, Castañeda-Gutiérrez E, et al. Postnatal growth in preterm infants and later health outcomes: a systematic review. Acta Paediatr 2015;104(10):974–986. DOI: 10.1111/apa.13128.
  2. Chan SH, Johnson MJ, Leaf AA, et al. Nutrition and neurodevelopmental outcomes in preterm infants: a systematic review. Acta Paediatr 2016;105(6):587–599. DOI: 10.1111/apa.13344.
  3. Hortensius LM, van Elburg RM, Nijboer CH, et al. Postnatal nutrition to improve brain development in the preterm infant: a systematic review from bench to bedside. Front Physiol 2019;10:961. DOI: 10.3389/fphys.2019.00961.
  4. Pfister KM, Zhang L, Miller NC, et al. Early body composition changes are associated with neurodevelopmental and metabolic outcomes at 4 years of age in very preterm infants. Pediatr Res 2018;84(5):713–718. DOI: 10.1038/s41390-018-0158-x.
  5. Bua J, Risso FM, Bin M, et al. Association between body composition at term equivalent age and Bayley scores at 2 years in preterm infants. J Perinatol 2021;41(8):1852–1858. DOI: 10.1038/s41372-021-01074-x.
  6. Frondas-Chauty A, Simon L, Flamant C, et al. Deficit of fat free mass in very preterm infants at discharge is associated with neurological impairment at age 2 years. J Pediatr 2018;196:301–304. DOI: 10.1016/j.jpeds.2017.12.017.
  7. Johnson MJ, Wootton SA, Leaf AA, et al. Preterm birth and body composition at term equivalent age: a systematic review and meta-analysis. Pediatrics 2012;130(3):e640–e649. DOI: 10.1542/peds.2011-3379.
  8. Ramel SE, Gray HL, Ode KL, et al. Body composition changes in preterm infants following hospital discharge: comparison with term infants. J Pediatr Gastroenterol Nutr 2011;53(3):333–338. DOI: 10.1097/MPG.0b013e3182243aa7.
  9. Ramel SE, Demerath EW, Gray HL, et al. The relationship of poor linear growth velocity with neonatal illness and two-year neurodevelopment in preterm infants. Neonatology 2012;102(1): 19–24. DOI: 10.1159/000336127.
  10. Bruckner M, Khan Z, Binder C, et al. Extremely preterm infants have a higher fat mass percentage in comparison to very preterm infants at term-equivalent age. Front Pediatr 2020;8:61. DOI: 10.3389/fped.2020.00061.
  11. Hamatschek C, Yousuf EI, Mollers LS, et al. Fat and fat-free mass of preterm and term infants from birth to six months: a review of current evidence. Nutrients 2020;12(2):288. DOI: 10.3390/nu12020288.
  12. Alja'nini Z, McNelis KM, Viswanathan S, et al. Infant body composition assessment in the neonatal intensive care unit (NICU) using air displacement plethysmography: strategies for implementation into clinical workflow. Clin Nutr ESPEN 06 2021;43:212–222. DOI: 10.1016/j.clnesp.2021.04.014.
  13. Nagel E, Hickey M, Teigen L, et al. Clinical application of body composition methods in premature infants. JPEN J Parenter Enteral Nutr 2020;44(5):785–795. DOI: 10.1002/jpen.1803.
  14. Norris T, Ramel SE, Catalano P, et al. New charts for the assessment of body composition, according to air-displacement plethysmography, at birth and across the first 6 mo of life. Am J Clin Nutr 2019;109(5): 1353–1360. DOI: 10.1093/ajcn/nqy377.
  15. Patel AL, Engstrom JL, Meier PP, et al. Calculating postnatal growth velocity in very low birth weight (VLBW) premature infants. J Perinatol 2009;29(9):618–622. DOI: 10.1038/jp.2009.55.
  16. Fenton TR, Anderson D, Groh-Wargo S, et al. An attempt to standardize the calculation of growth velocity of preterm infants-evaluation of practical bedside methods. J Pediatr 2018;196:77–83. DOI: 10.1016/j.jpeds.2017.10.005.
  17. Fenton TR, Chan HT, Madhu A, et al. Preterm infant growth velocity calculations: a systematic review. Pediatrics 2017;139(3):e20162045. DOI: 10.1542/peds.2016-2045.
  18. Bell KA, Matthews LG, Cherkerzian S, et al. Associations of growth and body composition with brain size in preterm infants. J Pediatr 2019;214:20–26.e22. DOI: 10.1016/j.jpeds.2019.06.062.
  19. Paviotti G, De Cunto A, Zennaro F, et al. Higher growth, fat and fat-free masses correlate with larger cerebellar volumes in preterm infants at term. Acta Paediatr 2017;106(6):918–925. DOI: 10.1111/apa.13829.
  20. Ramel SE, Gray HL, Christiansen E, et al. Greater early gains in fat-free mass, but not fat mass, are associated with improved neurodevelopment at 1 year corrected age for prematurity in very low birth weight preterm infants. J Pediatr 2016;173:108–115. DOI: 10.1016/j.jpeds.2016.03.003.
  21. Fusch C, Jochum F. Water, sodium, potassium and chloride. In: Koletzko B, Poindexter B, Uauy R, editors. Nutritional care of preterm infants: scientific basis and practical guidelines. World Rev Nutr Diet, vol. 110. Basel: Karger; 2014. p. 99–120.
  22. Wells JC, Davies PS, Hopkins M, et al. The “drive to eat” hypothesis: energy expenditure and fat-free mass but not adiposity are associated with milk intake and energy intake in 12 week infants. Am J Clin Nutr 2021;114(2):505–514. DOI: 10.1093/ajcn/nqab067.
  23. Davis SM, Kaar JL, Ringham BM, et al. Sex differences in infant body composition emerge in the first 5 months of life. J Pediatr Endocrinol Metab 2019;32(11):1235–1239. DOI: 10.1515/jpem-2019-0243.
  24. Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr 2013;13(1):59. DOI: 10.1186/1471-2431-13-59.
  25. Olsen IE, Groveman SA, Lawson ML, et al. New intrauterine growth curves based on United States data. Pediatrics 2010;125(2):e214–e224. DOI: 10.1542/peds.2009-0913.
  26. Cormack BE, Embleton ND, van Goudoever JB, et al. Comparing apples with apples: it is time for standardized reporting of neonatal nutrition and growth studies. Pediatr Res 2016;79(6):810–820. DOI: 10.1038/pr.2016.26.
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