Peer-reviewed article
Placental insufficiency and markers of fetal growth are associated with longitudinal infant growth and body composition trajectories up to two years of age.
Sanja Nel, Friedeburg Anna Maria Wenhold, Helen Mulol, Nonhlanhla Yende-Zuma, Ute Dagmar Feucht ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tracked growth and body composition in 81 South African infants from birth to two years, comparing those with and without placental insufficiency. Researchers used ultrasound measurements during pregnancy and multiple physical measurements after birth to understand how fetal conditions affect infant growth patterns. Lower birth weight and abnormal blood flow patterns in the umbilical artery during pregnancy were associated with slower growth and reduced muscle mass in infants. The findings suggest that screening for placental problems during pregnancy could help identify babies at risk of stunting.
Key points
- Lower birth weight z-score predicted slower trajectories for weight-for-age, weight-for-length, BMI-for-age, fat mass, and fat-free mass
- Higher (more abnormal) umbilical artery resistance index predicted slower length-for-age and fat-free mass trajectories
- Three distinct growth trajectory classes were identified for weight, length, weight-for-length, BMI, and fat-free mass measures
- Birth weight z-score was a stronger predictor of overall growth trajectories than placental insufficiency markers
- Umbilical artery resistance index screening could identify fetuses at increased risk of later stunting
Limitations
The study is observational and cannot establish causation. The sample size is relatively small (81 infants), which limits generalisability to other populations, and the study is limited to term-born infants in South Africa.
Abstract
Placental insufficiency affects fetal nutrition and growth. We describe two-year anthropometric and body composition trajectories in term-born South African infants with/without placental insufficiency, and early-life predictors thereof. Eighty-one infants were screened for placental insufficiency at 28-34 weeks’ gestation using Doppler-derived umbilical artery resistance index (UmA-RI). At eight postnatal time points, z-scores were calculated for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), BMI-for-age (BMIZ), and mid-upper arm circumference-for-age (MUACZ). Fat-free mass (FFM) and fat mass (FM) were assessed using deuterium dilution, and z-scores calculated for FM-for-age (FMZ), FFM-for-age (FFMZ), FM index-for-age (FMIZ), and FFM index-for-age (FFMIZ). Latent class trajectory modelling identified characteristic growth trajectories, and multivariable logistic models investigated predictors of growth trajectories. Three trajectory classes were identified for WAZ, LAZ, WLZ, BMIZ, and FFMZ, and two for MUACZ, FMZ, FMIZ, and FFMIZ. In multivariable analysis, lower birth weight z-score (BWZ) was associated with lower trajectories for WAZ (OR:9.32(95%CI:2.32-37.50)), WLZ (OR:2.95(95%CI:1.33-6.55)), BMIZ (OR:3.70(95%CI:1.56-9.09)), FMZ (OR:2.78(95%CI:1.37-5.55)), and FFMZ (OR:2.63(95%CI:1.45-4.76)). Higher (more abnormal) UmA-RI was associated with lower trajectories for LAZ (OR:1.95(95%CI:1.15-3.30) and FFMZ (OR:1.78(95%CI:1.13-2.80)). Thus, while BWZ predicts WAZ, WLZ, BMIZ, FMZ and FFMZ trajectories, UmA-RI predicts LAZ and FFMZ. Routine UmA-RI screening could identify fetuses at increased risk of later stunting.