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The effect of preterm birth on body composition at term equivalent age: a systematic review and meta-analysis
  1. M J Johnson,
  2. S A Wootton,
  3. A A Jackson
  1. NIHR Biomedical Research Unit (Nutrition, Diet and Lifestyle), Southampton, UK

Abstract

Background Preterm infants tend to be lighter and shorter on reaching term equivalent age (TEA) than those born full-term, but the effect of preterm birth on body composition (BC) is less clear. We conducted a systematic review to assess the effect of preterm birth on BC at TEA.

Methods The databases MEDLINE, EMBASE, CAB Abstracts, HMIC, ‘Web of Science’ and ‘CSA-Conference Papers Index’ were searched between 1947 and January 2011, with selective citation and reference searching. Included studies needed to have directly compared the BC of preterm infants (born <37 weeks) at TEA with infants born full-term. Meta-analysis was performed using the random effects model.

Results Seven studies were included. There were 371 infants in the preterm group and 291 in the full-term group. Gestational ages and weights at birth (mean±SD) were 30.0±2.7 weeks and 1.23±0.31 kg in the pre-term group and 39.3±1.3 weeks and 3.45±0.61 kg in the full-term group.

Meta-analysis showed that preterm infants had significantly lower weight, length and head circumference at TEA (mean differences 570 g, 3.8 cm and 1 cm respectively, p<0.00001 for all). The preterm infants had greater total body fat per unit body weight at TEA than those born full-term (mean difference 2.7%, p=0.05).

Conclusions Preterm infants are shorter and lighter at TEA, with a significantly greater proportion of body fat relative to body weight compared to infants born full-term. These findings demonstrate that weight is an insufficient criterion for assessing nutritional outcome in preterm infants, and robust measures of BC are required in addition to standard anthropometry.

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