背景:超重和肥胖及其随之而来的发病率是重要的全球健康问题。一些研究表明,过度肥胖的起源可能始于胎儿时期,但未知的是这是否适用于早产婴儿。
目的:本研究的目的是评估早产者中小于胎龄儿(SGA)出生与后期肥胖和身高之间的关系。
方法:MEDLINE,EMBASE和CINAHL至2022年10月。
方法:如果研究报告了SGA与非SGA早产参与者的人体测量(肥胖测量和身高)结果,则纳入研究。筛选,数据提取和偏倚风险评估由两名审阅者一式两份进行.
结果:我们使用随机效应模型对所有研究进行了荟萃分析,并探索了潜在的异质性来源。
结果:39项研究符合纳入标准。在以后的生活中,早产SGA婴儿的体重指数较低(-0.66kg/m2,95%CI-0.79,-0.53;32项研究,I2=16.7,n=30,346),腰围(-1.20厘米,95%CI-2.17,-0.23;13项研究,I2=19.4,n=2061),贫质量(-2.62kg,95%CI-3.45,1.80;7项研究,I2=0,n=205)和高度(-3.85厘米,95%CI-4.73,-2.96;26项研究,I2=52.6,n=4174)与非SGA出生的早产儿相比。早产SGA组和早产非SGA组的腰臀比无差异,身体脂肪,身体脂肪百分比,躯干脂肪百分比,脂肪质量指数或瘦体重指数,尽管某些分析的能力有限。由于潜在的残留混杂因素和其他领域的低偏倚风险,研究被评为高偏倚风险。
结论:与早产非SGA同龄人相比,SGA出生的早产儿BMI较低,腰围,瘦体重和身高在以后的生活中。在SGA早产儿和非SGA早产儿之间没有观察到肥胖的差异。
BACKGROUND: Overweight and obesity and their consequent morbidities are important worldwide health problems. Some research suggests excess adiposity origins may begin in fetal life, but unknown is whether this applies to infants born preterm.
OBJECTIVE: The objective of the study was to assess the association between small for gestational age (SGA) birth and later adiposity and height among those born preterm.
METHODS: MEDLINE, EMBASE and CINAHL until October 2022.
METHODS: Studies were included if they reported anthropometric (adiposity measures and height) outcomes for participants born preterm with SGA versus non-SGA. Screening, data extraction and risks of bias assessments were conducted in duplicate by two reviewers.
RESULTS: We meta-analysed across studies using random-effects models and explored potential heterogeneity sources.
RESULTS: Thirty-nine studies met the inclusion criteria. In later life, preterm SGA infants had a lower body mass index (-0.66 kg/m2 , 95% CI -0.79, -0.53; 32 studies, I2 = 16.7, n = 30,346), waist circumference (-1.20 cm, 95% CI -2.17, -0.23; 13 studies, I2 = 19.4, n = 2061), lean mass (-2.62 kg, 95% CI -3.45, 1.80; 7 studies, I2 = 0, n = 205) and height (-3.85 cm, 95% CI -4.73, -2.96; 26 studies, I2 = 52.6, n = 4174) compared with those preterm infants born non-SGA. There were no differences between preterm SGA and preterm non-SGA groups in waist/hip ratio, body fat, body fat per cent, truncal fat per cent, fat mass index or lean mass index, although power was limited for some analyses. Studies were rated at high risk of bias due to potential residual confounding and low risk of bias in other domains.
CONCLUSIONS: Compared to their preterm non-SGA peers, preterm infants born SGA have lower BMI, waist circumference, lean body mass and height in later life. No differences in adiposity were observed between SGA preterm infants and non-SGA preterm infants.