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Systemic inflammation predicts obesity at 2 years of life in premature babies

19 Jul 2018

Elevations in inflammatory protein levels in neonatal blood are associated with obesity among 2-year-old children born extremely premature, a study reports. This suggests that systemic inflammation contributes to the development of obesity. 

Researchers evaluated serum concentrations of 25 inflammation-related proteins in 882 infants born before 28 gestational weeks. Blood samples were obtained during the first two postnatal weeks, while body mass index was measured at 2 years of age.

In the subgroup of children delivered for spontaneous indications (n=734), obesity correlated with increased concentrations of four proteins (IL-1β, IL-6, TNF-R1 and MCP-1) at the first postnatal day, of one protein (IL-6) at postnatal day 7, and of two proteins (ICAM-3 and VEGF-R1) at postnatal day 14.

In the subgroup of children delivered for maternal or foetal indications (n=148), on the other hand, obesity was associated with elevated concentrations of seven proteins at postnatal day 14.

Multivariable logistic regression models in the spontaneous indication subgroup demonstrated that increased IL-6 levels at day 1 predicted obesity (odds ratio [OR], 2.9; 95 percent CI, 1.2–6.8), whereas elevated VCAM-1 at day 14 predicted overweight at 2 years of age (OR, 2.3; 95 percent CI, 1.2–4.3).

Researchers noted that the association observed between perinatal systemic inflammation and childhood obesity might be an evidence of foetal programming, such that inflammation could be an early expression of the developmental programming that leads to adiposity in later childhood.

Alternatively, the later development of childhood obesity among the infant population might be attributed to behavioural factors. Researchers highlighted the possibility that parents and other caregivers who perceive preterm newborns as vulnerable might respond by overfeeding in order to encourage catch-up growth.

Additional work is required to examine whether the present data can be replicated among children born very preterm, as well as assess if similar foetal programming is manifest in children born at term. This will facilitate improved understanding of the multitude of factors involved in the complex development of obesity, and aid in the prevention and management of obesity in turn, researchers said.

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