Randomized Controlled Trial

. 2018 Sep:200:132-139.e3.

doi: 10.1016/j.jpeds.2018.04.073. Epub 2018 May 21.

Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort

Betty R Vohr¹, Roy Heyne², Carla M Bann³, Abhik Das⁴, Rosemary D Higgins⁵, Susan R Hintz⁶; Eunice Kennedy Shriver National Institute of Child Health, and Development Neonatal Research Network

Collaborators, Affiliations

Collaborators

Eunice Kennedy Shriver National Institute of Child Health, and Development Neonatal Research Network:
Alan H Jobe⁷, Michael S Caplan⁸, Richard A Polin⁹, Abbot R Laptook¹⁰, Angelita M Hensman¹⁰, Elisabeth C McGowan¹⁰, Elisa Vieira¹⁰, Emilee Little¹⁰, Katharine Johnson¹⁰, Barbara Alksninis¹⁰, Mary Lenore Keszler¹⁰, Andrea M Knoll¹⁰, Theresa M Leach¹⁰, Victoria E Watson¹⁰, Michele C Walsh¹¹, Avroy A Fanaroff¹¹, Deanne E Wilson-Costello¹¹, Allison Payne¹¹, Nancy S Newman¹¹, H Gerry Taylor¹¹, Bonnie S Siner¹¹, Arlene Zadell¹¹, Julie DiFiore¹¹, Monika Bhola¹¹, Harriet G Friedman¹¹, Gulgun Yalcinkaya¹¹, Dorothy Bulas¹², Ronald N Goldberg¹³, C Michael Cotten¹³, Ricki F Goldstein¹³, Kathryn E Gustafson¹³, Patricia Ashley¹³, Kathy J Auten¹³, Kimberley A Fisher¹³, Katherine A Foy¹³, Sharon F Freedman¹³, Melody B Lohmeyer¹³, William F Malcolm¹³, David K Wallace¹³, David P Carlton¹⁴, Barbara J Stoll¹⁴, Ira Adams-Chapman¹⁴, Susie Buchter¹⁴, Anthony J Piazza¹⁴, Carter¹⁴, Sobha Fritz¹⁴, Ellen C Hale¹⁴, Amy K Hutchinson¹⁴, Maureen Mulligan LaRossa¹⁴, Yvonne Loggins¹⁴, Diane Bottcher¹⁴, Stephanie Wilson Archer¹⁵, Brenda B Poindexter¹⁶, Gregory M Sokol¹⁶, Heidi M Harmon¹⁶, Lu-Ann Papile¹⁶, Abbey C Hines¹⁶, Leslie D Wilson¹⁶, Dianne E Herron¹⁶, Lucy Smiley¹⁶, Kathleen A Kennedy¹⁷, Jon E Tyson¹⁷, Andrea Freeman Duncan¹⁷, Allison G Dempsey¹⁷, Janice John¹⁷, Patrick M Jones¹⁷, M Layne Lillie¹⁷, Saba Siddiki¹⁷, Daniel K Sperry¹⁷, Mary Anne Berberich¹⁸, Carol J Blaisdell¹⁸, Dorothy B Gail¹⁸, James P Kiley¹⁸, Dennis Wallace¹⁹, Marie G Gantz¹⁹, Jamie E Newman¹⁹, Jeanette O'Donnell Auman¹⁹, Jane A Hammond¹⁹, W Kenneth Poole¹⁹, Krisa P Van Meurs²⁰, David K Stevenson²⁰, Maria Elena DeAnda²⁰, M Bethany Ball²⁰, Gabrielle T Goodlin²⁰, Ivan D Frantz 3rd²¹, John M Fiascone²¹, Elisabeth C McGowan²¹, Anne Furey²¹, Brenda L MacKinnon²¹, Ellen Nylen²¹, Ana Brussa²¹, Cecelia Sibley²¹, Waldemar A Carlo²², Namasivayam Ambalavanan²², Myriam Peralta-Carcelen²², Monica V Collins²², Shirley S Cosby²², Vivien A Phillips²², Kirstin J Bailey²², Fred J Biasini²², Maria Hopkins²², Kristen C Johnston²², Kathleen G Nelson²², Cryshelle S Patterson²², Richard V Rector²², Leslie Rodriguez²², Amanda Soong²², Sally Whitley²², Sheree York²², Kristy Guest²², Leigh Ann Smith²², Neil N Finer²³, Donna Garey²³, Maynard R Rasmussen²³, Paul R Wozniak²³, Yvonne E Vaucher²³, Martha G Fuller²³, Natacha Akshoomoff²³, Wade Rich²³, Kathy Arnell²³, Renee Bridge²³, Edward F Bell²⁴, Tarah T Colaizy²⁴, John A Widness²⁴, Jonathan M Klein²⁴, Karen J Johnson²⁴, Michael J Acarregui²⁴, Diane L Eastman²⁴, Tammy L V Wilgenbusch²⁴, Kristi L Watterberg²⁵, Robin K Ohls²⁵, Janell Fuller²⁵, Jean Lowe²⁵, Julie Rohr²⁵, Conra Backstrom Lacy²⁵, Rebecca Montman²⁵, Sandra Brown²⁵, Pablo J Sánchez²⁶, Charles R Rosenfeld²⁶, Walid A Salhab²⁶, Luc Brion²⁶, Sally S Adams²⁶, James Allen²⁶, Laura Grau²⁶, Alicia Guzman, Gaynelle Hensley²⁶, Elizabeth T Heyne²⁶, Jackie F Hickman²⁶, Melissa H Leps²⁶, Linda A Madden²⁶, Melissa Martin²⁶, Nancy A Miller²⁶, Janet S Morgan²⁶, Araceli Solis²⁶, Lizette E Lee²⁶, Catherine Twell Boatman²⁶, Diana M Vasil²⁶, Bradley A Yoder²⁷, Roger G Faix²⁷, Sarah Winter²⁷, Shawna Baker²⁷, Karen A Osborne²⁷, Carrie A Rau²⁷, Sean Cunningham²⁷, Ariel Ford²⁷, Seetha Shankaran²⁸, Athina Pappas²⁸, Beena G Sood²⁸, Rebecca Bara²⁸, Thomas L Slovis²⁸, Elizabeth Billian²⁸, Laura A Goldston²⁸, Mary Johnson²⁸

Affiliations

¹ Department of Pediatrics, Division of Neonatal Medicine, Women & Infants Hospital and Alpert Medical School of Brown University, Providence, RI. Electronic address: bvohr@wihri.org.
² Department of Pediatrics, Division of Neonatal Medicine, UT Southwestern, Dallas, TX.
³ Social Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC.
⁴ Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD.
⁵ National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
⁶ Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
⁷ University of Cincinnati.
⁸ Pritzker School of Medicine, University of Chicago.
⁹ Division of Neonatology, College of Physicians and Surgeons, Columbia University.
¹⁰ Rainbow Babies & Children's Hospital, Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island.
¹¹ Case Western Reserve University.
¹² Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.
¹³ University Hospital, Duke Regional Hospital, Duke University School of Medicine.
¹⁴ Children's Healthcare of Atlanta, Grady Memorial Hospital, and Emory Crawford Long Hospital, Emory University.
¹⁵ Eunice Kennedy Shriver National Institute of Child Health and Human Development.
¹⁶ University Hospital, Methodist Hospital, Riley Hospital for Children, and Wishard Health Services, Indiana University.
¹⁷ McGovern Medical School, Children's Memorial Hermann Hospital, The University of Texas Health Science Center at Houston.
¹⁸ National Heart, Lung, and Blood Institute.
¹⁹ RTI International.
²⁰ Lucile Packard Children's Hospital, Stanford University.
²¹ Floating Hospital for Children, Tufts Medical Center.
²² University of Alabama at Birmingham Health System and Children's Hospital of Alabama.
²³ San Diego Medical Center and Sharp Mary Birch Hospital for Women, University of California.
²⁴ University of Iowa.
²⁵ University of New Mexico Health Sciences Center.
²⁶ Parkland Health & Hospital System, and Children's Medical Center Dallas, University of Texas Southwestern Medical Center at Dallas.
²⁷ Intermountain Medical Center, LDS Hospital, Primary Children's Medical Center, University of Utah Medical Center.
²⁸ Hutzel Women's Hospital, Children's Hospital of Michigan, Wayne State University.

PMID: 29793869
PMCID: PMC6109599
DOI: 10.1016/j.jpeds.2018.04.073

Randomized Controlled Trial

Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort

Betty R Vohr et al. J Pediatr. 2018 Sep.

. 2018 Sep:200:132-139.e3.

doi: 10.1016/j.jpeds.2018.04.073. Epub 2018 May 21.

Authors

Collaborators

Eunice Kennedy Shriver National Institute of Child Health, and Development Neonatal Research Network:
Alan H Jobe⁷, Michael S Caplan⁸, Richard A Polin⁹, Abbot R Laptook¹⁰, Angelita M Hensman¹⁰, Elisabeth C McGowan¹⁰, Elisa Vieira¹⁰, Emilee Little¹⁰, Katharine Johnson¹⁰, Barbara Alksninis¹⁰, Mary Lenore Keszler¹⁰, Andrea M Knoll¹⁰, Theresa M Leach¹⁰, Victoria E Watson¹⁰, Michele C Walsh¹¹, Avroy A Fanaroff¹¹, Deanne E Wilson-Costello¹¹, Allison Payne¹¹, Nancy S Newman¹¹, H Gerry Taylor¹¹, Bonnie S Siner¹¹, Arlene Zadell¹¹, Julie DiFiore¹¹, Monika Bhola¹¹, Harriet G Friedman¹¹, Gulgun Yalcinkaya¹¹, Dorothy Bulas¹², Ronald N Goldberg¹³, C Michael Cotten¹³, Ricki F Goldstein¹³, Kathryn E Gustafson¹³, Patricia Ashley¹³, Kathy J Auten¹³, Kimberley A Fisher¹³, Katherine A Foy¹³, Sharon F Freedman¹³, Melody B Lohmeyer¹³, William F Malcolm¹³, David K Wallace¹³, David P Carlton¹⁴, Barbara J Stoll¹⁴, Ira Adams-Chapman¹⁴, Susie Buchter¹⁴, Anthony J Piazza¹⁴, Carter¹⁴, Sobha Fritz¹⁴, Ellen C Hale¹⁴, Amy K Hutchinson¹⁴, Maureen Mulligan LaRossa¹⁴, Yvonne Loggins¹⁴, Diane Bottcher¹⁴, Stephanie Wilson Archer¹⁵, Brenda B Poindexter¹⁶, Gregory M Sokol¹⁶, Heidi M Harmon¹⁶, Lu-Ann Papile¹⁶, Abbey C Hines¹⁶, Leslie D Wilson¹⁶, Dianne E Herron¹⁶, Lucy Smiley¹⁶, Kathleen A Kennedy¹⁷, Jon E Tyson¹⁷, Andrea Freeman Duncan¹⁷, Allison G Dempsey¹⁷, Janice John¹⁷, Patrick M Jones¹⁷, M Layne Lillie¹⁷, Saba Siddiki¹⁷, Daniel K Sperry¹⁷, Mary Anne Berberich¹⁸, Carol J Blaisdell¹⁸, Dorothy B Gail¹⁸, James P Kiley¹⁸, Dennis Wallace¹⁹, Marie G Gantz¹⁹, Jamie E Newman¹⁹, Jeanette O'Donnell Auman¹⁹, Jane A Hammond¹⁹, W Kenneth Poole¹⁹, Krisa P Van Meurs²⁰, David K Stevenson²⁰, Maria Elena DeAnda²⁰, M Bethany Ball²⁰, Gabrielle T Goodlin²⁰, Ivan D Frantz 3rd²¹, John M Fiascone²¹, Elisabeth C McGowan²¹, Anne Furey²¹, Brenda L MacKinnon²¹, Ellen Nylen²¹, Ana Brussa²¹, Cecelia Sibley²¹, Waldemar A Carlo²², Namasivayam Ambalavanan²², Myriam Peralta-Carcelen²², Monica V Collins²², Shirley S Cosby²², Vivien A Phillips²², Kirstin J Bailey²², Fred J Biasini²², Maria Hopkins²², Kristen C Johnston²², Kathleen G Nelson²², Cryshelle S Patterson²², Richard V Rector²², Leslie Rodriguez²², Amanda Soong²², Sally Whitley²², Sheree York²², Kristy Guest²², Leigh Ann Smith²², Neil N Finer²³, Donna Garey²³, Maynard R Rasmussen²³, Paul R Wozniak²³, Yvonne E Vaucher²³, Martha G Fuller²³, Natacha Akshoomoff²³, Wade Rich²³, Kathy Arnell²³, Renee Bridge²³, Edward F Bell²⁴, Tarah T Colaizy²⁴, John A Widness²⁴, Jonathan M Klein²⁴, Karen J Johnson²⁴, Michael J Acarregui²⁴, Diane L Eastman²⁴, Tammy L V Wilgenbusch²⁴, Kristi L Watterberg²⁵, Robin K Ohls²⁵, Janell Fuller²⁵, Jean Lowe²⁵, Julie Rohr²⁵, Conra Backstrom Lacy²⁵, Rebecca Montman²⁵, Sandra Brown²⁵, Pablo J Sánchez²⁶, Charles R Rosenfeld²⁶, Walid A Salhab²⁶, Luc Brion²⁶, Sally S Adams²⁶, James Allen²⁶, Laura Grau²⁶, Alicia Guzman, Gaynelle Hensley²⁶, Elizabeth T Heyne²⁶, Jackie F Hickman²⁶, Melissa H Leps²⁶, Linda A Madden²⁶, Melissa Martin²⁶, Nancy A Miller²⁶, Janet S Morgan²⁶, Araceli Solis²⁶, Lizette E Lee²⁶, Catherine Twell Boatman²⁶, Diana M Vasil²⁶, Bradley A Yoder²⁷, Roger G Faix²⁷, Sarah Winter²⁷, Shawna Baker²⁷, Karen A Osborne²⁷, Carrie A Rau²⁷, Sean Cunningham²⁷, Ariel Ford²⁷, Seetha Shankaran²⁸, Athina Pappas²⁸, Beena G Sood²⁸, Rebecca Bara²⁸, Thomas L Slovis²⁸, Elizabeth Billian²⁸, Laura A Goldston²⁸, Mary Johnson²⁸

Affiliations

¹ Department of Pediatrics, Division of Neonatal Medicine, Women & Infants Hospital and Alpert Medical School of Brown University, Providence, RI. Electronic address: bvohr@wihri.org.
² Department of Pediatrics, Division of Neonatal Medicine, UT Southwestern, Dallas, TX.
³ Social Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC.
⁴ Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD.
⁵ National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
⁶ Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
⁷ University of Cincinnati.
⁸ Pritzker School of Medicine, University of Chicago.
⁹ Division of Neonatology, College of Physicians and Surgeons, Columbia University.
¹⁰ Rainbow Babies & Children's Hospital, Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island.
¹¹ Case Western Reserve University.
¹² Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.
¹³ University Hospital, Duke Regional Hospital, Duke University School of Medicine.
¹⁴ Children's Healthcare of Atlanta, Grady Memorial Hospital, and Emory Crawford Long Hospital, Emory University.
¹⁵ Eunice Kennedy Shriver National Institute of Child Health and Human Development.
¹⁶ University Hospital, Methodist Hospital, Riley Hospital for Children, and Wishard Health Services, Indiana University.
¹⁷ McGovern Medical School, Children's Memorial Hermann Hospital, The University of Texas Health Science Center at Houston.
¹⁸ National Heart, Lung, and Blood Institute.
¹⁹ RTI International.
²⁰ Lucile Packard Children's Hospital, Stanford University.
²¹ Floating Hospital for Children, Tufts Medical Center.
²² University of Alabama at Birmingham Health System and Children's Hospital of Alabama.
²³ San Diego Medical Center and Sharp Mary Birch Hospital for Women, University of California.
²⁴ University of Iowa.
²⁵ University of New Mexico Health Sciences Center.
²⁶ Parkland Health & Hospital System, and Children's Medical Center Dallas, University of Texas Southwestern Medical Center at Dallas.
²⁷ Intermountain Medical Center, LDS Hospital, Primary Children's Medical Center, University of Utah Medical Center.
²⁸ Hutzel Women's Hospital, Children's Hospital of Michigan, Wayne State University.

PMID: 29793869
PMCID: PMC6109599
DOI: 10.1016/j.jpeds.2018.04.073

Abstract

Objective: To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation.

Study design: Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed. Three groups were compared, those with a BMI ≥85th percentile (overweight or obese for age, height, and sex) and ≥95th percentile (obese) vs <85th percentile. Multiple regression analyses estimated the relative risks of BMI ≥85th percentile and ≥95th percentile associated with perinatal and early childhood factors.

Results: Of 388 children, 22% had a BMI of ≥85th percentile and 10% were obese. Children with obesity and overweight compared with normal weight children had higher body fat (subscapular skinfold and triceps skinfold >85th percentile), central fat (waist circumference >90th percentile), spent more time in sedentary activity (20.5 vs 18.2 vs 16.7 hours/week), and had either systolic and/or diastolic hypertension (24% vs 26% vs 14%), respectively. Postdischarge weight gain velocities from 36 weeks postmenstrual age to 18 months, and 18 months to 6-7 years were independently associated with a BMI of ≥85th percentile, whereas weight gain velocity from 18 months to 6-7 years was associated with obesity.

Conclusions: One in 5 former extremely preterm infants is overweight or obese and has central obesity at early school age. Postdischarge weight gain velocities were associated with overweight and obesity. These findings suggest the obesity epidemic is spreading to the most extremely preterm infants.

Trial registration: ClinicalTrials.gov: NCT00063063 and NCT0000.

Trial registration: ClinicalTrials.gov NCT00063063 NCT00000000.

Keywords: hypertension; obese; overweight; preterm; school age; sedentary activity.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**Figure 1. Weight and Height Z-Scores by Gender and BMI - online**
Note: Comparisons of BMI < 85^th% vs. BMI >= 85^th % significant at p < 0.001

See this image and copyright information in PMC

References

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Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort

Collaborators

Affiliations

Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

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