O059 - EARLY GROWTH TRAJECTORIES AND CHILDHOOD BODY COMPOSITION IN VERY PRETERM-BORN CHILDREN: IDENTIFYING CRITICAL WINDOWS FOR FAT-FREE MASS ACCRETION

O059

EARLY GROWTH TRAJECTORIES AND CHILDHOOD BODY COMPOSITION IN VERY PRETERM-BORN CHILDREN: IDENTIFYING CRITICAL WINDOWS FOR FAT-FREE MASS ACCRETION

A. Le Clercq^1,*, G. Hasperhoven¹, S. Willemsen^1,2, S. Verbruggen¹, E. Roze¹, K. Joosten¹

¹Department of Neonatal and Pediatric Intensive Care, ²Department of Biostatistics, Erasmus University Medical Center, Rotterdam, Netherlands

Rationale: Children born preterm are at risk for impaired growth and development. While body composition (BC), especially Fat-Free Mass (FFM), is more strongly associated with long-term outcomes than weight, BC measurement is not universally available and it is unclear which growth trajectories are associated with favorable BC in childhood. This study explores weight trajectories from birth to early childhood in preterm-born children and assesses whether specific intervals are associated with BC at school age.

Methods: This study included 140 children born <30 weeks gestation. Weight was measured 8 times from birth to 5.5 years corrected age (CA). At 5.5 years, BC was additionally measured using DXA. Standard Deviation Scores (SDS) were calculated for weight, FFM and Fat Mass (FM). Weight SDS trajectories were modeled using latent class linear mixed models. Furthermore, children were grouped based on FFM outcomes (above/below -1 SDS). Velocity of weight SDS change was compared between groups using linear mixed effect models.

Results: Two weight trajectories were identified: (1) weight SDS gain from birth to 5.5 years and (2) postnatal dip until 2 years with recovery until 4 years. Children assigned to the second trajectory had a lower FFM SDS (-1.10±1.01 vs 0.14±1.15, p<.001) and FM SDS at 5.5 years (0.02±1.09 vs -1.46±1.13, p<.001). Children with a FFM SDS≤-1 had a negative weight SDS velocity until 1.5 years, which remained lower than the FFM SDS>-1 group until 3 years. After this, velocity was similar, but weight SDS remained 1.5 SDS lower at 5.5 years.

Conclusion: Two distinct weight trajectories and associations with later BC were detected. Our findings specifically show the association between growth in weight SDS in the first 2 years and BC at 5.5 years, emphasizing the importance of medical and nutritional support after NICU discharge for long-term outcomes. 

Disclosure of Interest: None declared