Growth in foetal life and infancy is associated with abdominal adiposity at the age of 2 years: The Generation R Study

The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
Clinical Endocrinology (Impact Factor: 3.46). 09/2009; 72(5):633-40. DOI: 10.1111/j.1365-2265.2009.03708.x
Source: PubMed


Early weight gain is associated with an increased risk of obesity. It is not known whether rapid weight gain in foetal life and infancy is also associated with increased abdominal adiposity. We examined the associations of foetal and postnatal growth characteristics with abdominal fat mass at the age of 2 years.
This study was performed in 481 children participating in a prospective cohort study from early foetal life onward.
Foetal and postnatal growth characteristics in second and third trimester, at birth and at the age of 2 years were related to abdominal fat mass (subcutaneous distance and area, preperitoneal distance and area) measured by ultrasound at the age of 2 years.
Foetal and birth weight were not associated with abdominal subcutaneous fat mass. Estimated foetal weight in second trimester of pregnancy was inversely associated with preperitoneal fat area [-3.73% (95% confidence interval -7.23, -0.10)] per standard deviation score increase in weight. Weight gain from birth to the age of 2 years was positively associated with preperitoneal fat mass measures. These associations remained significant after adjustment for age, sex, breastfeeding and body mass index. Positive associations were found between catch-up growth in weight and abdominal fat mass measures.
Our results suggest that rapid growth rates during foetal life and infancy are associated with increased abdominal subcutaneous and preperitoneal fat mass in healthy children. Further studies need to explore whether these associations persist in later life and are related to metabolic syndrome outcomes.

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    ABSTRACT: The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health during fetal life, childhood and adulthood. The study focuses on six areas of research: (1) maternal health; (2) growth and physical development; (3) behavioural and cognitive development; (4) respiratory health and allergies; (5) diseases in childhood; and (6) health and healthcare for children and their parents. Main exposures of interest include environmental, endocrine, genetic and epigenetic, lifestyle related, nutritional and socio-demographic determinants. In total, n = 9,778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Response at baseline was 61 %, and general follow-up rates until the age of 6 years exceed 80 %. Data collection in mothers, fathers and children include questionnaires, detailed physical and ultrasound examinations, behavioural observations, and biological samples. A genome and epigenome wide association screen is available in the participating children. From the age of 5 years, regular detailed hands-on assessments are performed in a dedicated research center including advanced imaging facilities such as Magnetic Resonance Imaging. Eventually, results forthcoming from the Generation R Study contribute to the development of strategies for optimizing health and healthcare for pregnant women and children.
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    • "This association has been seen for obesity in adults and children, in high-income and low-income countries [8] [9] [10] and is consistent for cohorts over the last 80 years [8]. The " critical window " for the effects of growth is not known, but slower weight gain in the first few weeks (regardless of gestation or birth weight) is associated with a lower risk of later obesity [11] [12], insulin resistance [13], endothelial dysfunction [5], and adult obesity [14]. Therefore, differences in weight gain between formula-and breast-fed infants in the first postnatal weeks, when breastfed babies often lose weight compared to weight gain in babies given formula [15] [16], could partially explain longterm programming advantages of breastfeeding [6]. "
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    • "Several studies determined an association between weight gain in the first 2-3 years of life and central adiposity, mostly assessed by larger waist circumference , in both adulthood [7] and early childhood [8– 13]. Imaging techniques such as magnetic resonance imaging [7], ultrasonography [10] [11], or computed tomography have seldom or never been used to assess the association between postnatal growth and later central adiposity. While in these studies weight gain in the first years of life was studied, the importance of particularly the first 3 months of life in the development of central adiposity was addressed in other studies in children [14] and adults [15] [16] [17]. "
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