The relationship of newborn adiposity to fetal growth outcome based on birth weight or the modified neonatal growth assessment score

Abstract

Objectives: (1) Develop reference ranges of neonatal adiposity using air displacement plethysmography. (2) Use new reference ranges for neonatal adiposity to compare two different methods of evaluating neonatal nutritional status. Methods: Three hundred and twenty-four normal neonates (35–41 weeks post-menstrual age) had body fat (%BF) and total fat mass (FM, g) measured using air displacement plethysmography shortly after delivery. Results were stratified for 92 of these neonates with corresponding fetal biometry using two methods for classifying nutritional status: (1) population-based weight percentiles; and (2) a modified neonatal growth assessment score (m₃NGAS₅₁). Results: At the 50th percentile, %BF varied from 7.7% (35 weeks) to 11.8% (41 weeks), while the corresponding 50th percentiles for total FM were 186–436 g. Among the subset of 92 neonates, no significant differences in adiposity were found between small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA) groups using population-based weight standards. Classification of the same neonates using m₃NGAS₅₁ showed significant differences in mean %BF between corresponding groups. Conclusions: Population-based weight criteria for neonatal nutritional status can lead to misclassifications on the basis of adiposity. A neonatal growth assessment score, that considers the growth potential of several anatomic parameters, appears to more effectively classify under- and over-nourished newborns.

Keywords::

• Air displacement plethysmography
• body composition
• body fat
• fetus
• malnutrition
• ultrasound

Acknowledgements

The Authors wish to acknowledge the technical assistance of Melissa Powell, RDMS; Beverley McNie, BS, CCRP; Elizabeth Kring, RNC, BSN, CCRC; and Jennifer DeRidder, RN, BSN.

Declaration of Interest: This research was supported (in part) by the Perinatology Research Branch, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS. R. Romero contributed to this work as part of his official duties as an employee of the United States Federal Government. None of the other authors have disclosed a conflict of interest.