Home Medicine Growth attainment in German children born preterm, and cardiovascular risk factors in adolescence. Analysis of the population representative KiGGS data
Article
Licensed
Unlicensed Requires Authentication

Growth attainment in German children born preterm, and cardiovascular risk factors in adolescence. Analysis of the population representative KiGGS data

  • Renate L. Bergmann EMAIL logo , Karl E. Bergmann , Rolf Richter , Martin Schlaud , Wolfgang Henrich and Alexander Weichert
Published/Copyright: February 25, 2017

Abstract

Aim:

To compare the growth attainment of preterm children and their cardiovascular risk factors at adolescence with the values measured in term children in Germany.

Methods:

About 17,641 children aged 0 to <18 years were studied between 2003 and 2006 in the population representative German KiGGS survey (“German Health Interview and Examination Survey for Children and Adolescents”) using questionnaires, physical examinations, standardized anthropometric and blood pressure measurements, and blood sample analyses. Analysis of covariance (ANCOVA) was employed for the analyses of anthropometric parameters.

Results:

About 11.8% of the 16,737 children with complete and valid data had been born preterm. After adjustment for covariates the estimated z-scores over the total age range were larger in term compared to preterm children for length/height (P<0.001; estimated difference B=0.277, 95% CI 0.191–0.362), head circumference (P<0.001; B=0.238, 95% CI 0.144–0.333), BMI (P=0.001; B=0.160, 95% CI 0.069–0.252), and skinfold thickness (P=0.220; B=0.058, 95% CI −0.035 to 0.151). The onset of pubertal development was slightly (but not significantly) earlier in term compared to preterm children. At 14 to <18 years, anthropometric and biochemical indicators of cardiovascular diseases were not worse in preterm compared to term children.

Conclusions:

Preterm-born German adolescents remained significantly shorter, lighter, and had a smaller head circumference than term-born adolescents, but the risk indicators for cardiovascular diseases were not higher.

  1. Author’s Statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

References

[1] Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012;379:2162–72.10.1097/01.aoa.0000432360.25014.c3Search in Google Scholar

[2] Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. for the Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012;379:2151–61.10.1016/S0140-6736(12)60560-1Search in Google Scholar

[3] Bayman E, Drake AJ, Piyasena CH. Prematurity and programming of cardiovascular disease risk: a future challenge for public health? Arch Dis Child Fetal Neonatal Ed. 2014;99:F510–4.10.1136/archdischild-2014-306742Search in Google Scholar

[4] Babson SG. Growth of low-birth-weight infants. J Pediatr. 1970;77:11–8.10.1016/S0022-3476(70)80039-7Search in Google Scholar

[5] Ross G, Lipper EG, Auld PAM. Physical growth and developmental outcome in very low birth weight premature infants at 3 years of age. J Pediatr. 1985;107:284–6.10.1016/S0022-3476(85)80151-7Search in Google Scholar

[6] Farooqi A, Hägglöf B, Sedin G, MD, Gothefors L, Serenius F. Growth in 10- to 12-year-old children born at 23 to 25 weeks’ gestation in the 1990s: a Swedish national prospective follow-up study. Pediatrics. 2006;118:e1452–65.10.1542/peds.2006-1069Search in Google Scholar PubMed

[7] Renes JS, Willemsen RH, Mulder JC, Bakker-van Waarde WM, Rotteveel J, Ostdijk ECAM, et al. New insights into factors influencing adult height in short SGA children: Results of a large multicentre growth hormone trial. Clin Endocrinol. 2015;82:854–61.10.1111/cen.12677Search in Google Scholar PubMed

[8] Johnson MJ, Wootton SA, Leaf AA, Jackson AA. Preterm birth and body composition at term equivalent age: a systematic review and meta-analysis. Pediatrics. 2012;130:e640–8.10.1542/peds.2011-3379Search in Google Scholar PubMed

[9] Yajnik CS, Lubree HG, Rege SS, Naik SS, Deshpande JA, Deshpande SS, et al. Adiposity and hyperinsulinemia in Indians are present at birth. Clin Endocrinol Metabol. 2002;87:5575–80.10.1210/jc.2002-020434Search in Google Scholar PubMed

[10] Barker DJP. The developmental origins of adult disease. Review. J Am Coll Nutr. 2004;23:588S–95S10.1080/07315724.2004.10719428Search in Google Scholar PubMed

[11] Pilgaard K, Færch K, Carstensen B, Poulsen P, Pisinger C, Pedersen O, et al. Low birthweight and premature birth are both associated with type 2 diabetes in a random sample of middle-aged Danes. Diabetologia. 2010;53:2526–30.10.1007/s00125-010-1917-3Search in Google Scholar PubMed

[12] Singhal A, Wells J, Cole TJ, Fewtrell M, Lucas A. Programming of lean body mass: a link between birth weight, obesity, and cardiovascular disease? Am J Clin Nutr. 2003;77:726–30.10.1093/ajcn/77.3.726Search in Google Scholar PubMed

[13] Rossi P, Gaudart J, Frances Y. Respective roles of preterm birth and fetal growth restriction in blood pressure and arterial stiffness in adolescence. J Adolescent Health. 2011;48:520–2.10.1016/j.jadohealth.2010.08.004Search in Google Scholar PubMed

[14] Bergmann KE, Thefeld W, Kurth B-M. Der Kinder- und Jugendgesundheitssurvey soll die gesundheitliche Situation der Kinder und Jugendlichen in Deutschland beschreiben. Monatsschrift Kinderheilkunde. 2002;150:1543–5.Search in Google Scholar

[15] Weichert A, Weichert TM, Bergmann RL, Henrich W, Kalache KD, Richter R, et al. Einflussfaktoren auf die Frühgeburt in Deutschland – Analyse der für Deutschland repräsentativen KiGGS-Daten. Factors for Preterm Births in Germany – An Analysis of Representative German Data (KiGGS). Geburtshilfe und Frauenheilkunde. 2015;75:819–26.10.1055/s-0035-1557817Search in Google Scholar PubMed PubMed Central

[16] Kurth BM, Kamtsiuris P, Hölling H, Schlaud M. The challenge of comprehensively mapping children’s health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health. 2008;8:196–203.10.1186/1471-2458-8-196Search in Google Scholar PubMed PubMed Central

[17] Neuhauser H, Schienkiewitz A, Schaffrath Rosario A, Dortschy R, Kurth B-M. Referenzperzentile für anthropometrische Maßzahlen und Blutdruck aus der Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS), 2nd ed. Robert Koch-Institute Berlin, 2013.Search in Google Scholar

[18] Kahl H, Schaffrath Rosario A, Schlaud M. Sexuelle Reifung von Kindern und Jugendlichen in Deutschland. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz. 2007;50:677–85.10.1007/s00103-007-0229-3Search in Google Scholar PubMed

[19] Thierfelder W, Dortschy R, Hintzpeter B, Kahl H, Scheidt-Nave C. Biochemische Messparameter im Kinder- und Jugendgesundheitssurvey (KiGGS). Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz. 2007;50:757–70.10.1007/s00103-007-0238-2Search in Google Scholar PubMed

[20] Bergmann KE, Schlack R, von Dewitz Ch, Dippelhofer A, Kurth B-M, Eichstädt H. Ethische und rechtliche Aspekte der epidemiologischen Forschung mit Kindern und Jugendlichen in Deutschland am Beispiel des Kinder- und Jugendgesundheitssurveys. Ethik in der Medizin. 2004;16:22–36.10.1007/s00481-004-0279-0Search in Google Scholar

[21] De Onis M, Onyango AW, Borghi E, Siyam A, Nishida Ch, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. B World Health Organ. 2007;85:660–7.10.2471/BLT.07.043497Search in Google Scholar PubMed PubMed Central

[22] Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, et al. Perzentile für den Body-Mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift für Kinderheilkunde. 2001;149:807–18.10.1007/s001120170107Search in Google Scholar

[23] Walther FJ, den Ouden AL, Verloove-Vanhorick SP. Looking back in time: outcome of a national cohort of very preterm infants born in The Netherlands in 1983. Early Hum Dev. 2000;59: 175–91.10.1016/S0378-3782(00)00094-3Search in Google Scholar

[24] Singer D. Langzeitüberleben von Frühgeborenen. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz. 2012;55:568–75.10.1007/s00103-012-1453-zSearch in Google Scholar

[25] Hutcheon JA, Platt RW. The missing data problem in birth weight percentiles and thresholds for ‘‘small for-gestational-age’’. Am J Epidemiol. 2008;167:786–92.10.1093/aje/kwm327Search in Google Scholar

[26] Kramer MS. Comment. Born too small or too soon. Lancet Global Health. 2013;1:e7–8.10.1016/S2214-109X(13)70014-7Search in Google Scholar

[27] Cole TJ. The development of growth references and growth charts. Ann Hum Biol. 2012;39:382–4.10.3109/03014460.2012.694475Search in Google Scholar PubMed PubMed Central

[28] Euser AM, de Wit CC, Finken MJJ, Rijken M, Wit JM. Growth of preterm born children. Horm Res. 2008;70:319–32.10.1159/000161862Search in Google Scholar PubMed

[29] Hack M, Schluchter M, Cartar L, Rahman M, Cuttle L, Borawski E. Growth of very low birth weight infants to age 20 years. Pediatrics. 2003;112:e30–8.10.1542/peds.112.1.e30Search in Google Scholar PubMed

[30] Gale CR, Finbar J, O’Callaghan FJ, Bredow M, Martyn CN, the Avon Longitudinal Study of Parents and Children Study Team. The influence of head growth in fetal life, infancy, and childhood on intelligence at the ages of 4 and 8 years. Pediatrics. 2006;118:1486–92.10.1542/peds.2005-2629Search in Google Scholar PubMed

[31] Ranke MB, Krägeloh-Mann I, Vollmer B. Growth, head growth, and neurocognitive outcome in children born very preterm: methodological aspects and selected results. Dev Med Child Neurol. 2015;57:23–8.10.1111/dmcn.12582Search in Google Scholar PubMed

[32] Kirchengast S. Gender differences in body composition from childhood to old age: an evolutionary point of view. J Life Sci. 2010;2:1–10.10.1080/09751270.2010.11885146Search in Google Scholar

[33] Lucas A. Long-term programming effects of early nutrition. Implications for the preterm infant. J Perinatol. 2005;25: S2–6.10.1038/sj.jp.7211308Search in Google Scholar PubMed

[34] Wells JCK, Chomtho S, Fewtrell MS. Programming of body composition by early growth and nutrition. Proc Nutr Soc. 2007;66:423–34.10.1017/S0029665107005691Search in Google Scholar PubMed

[35] Bergmann RL, Bergmann KE, Dudenhausen JW. Undernutrition and growth restriction in pregnancy. In: Barker DJP, Bergmann RL, Ogra PL, editors. The window of opportunity: pre-pregnancy to 24 months of age. Nestlé Nutrition Workshop Series Pediatric Program, Vol. 61, Basel: Karger AG, 2008:103–21.Search in Google Scholar

[36] Hales CN, Barker DJP, Clark PMS, Cox LJ, Fall C, Osmond C, Winter PD. Fetal and infant growth and impaired glucose tolerance at age 64. Br Med J. 1991;33:1019–22.10.1136/bmj.303.6809.1019Search in Google Scholar PubMed PubMed Central

Received: 2016-9-4
Accepted: 2016-11-30
Published Online: 2017-2-25
Published in Print: 2017-7-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review articles
  3. Mycoplasma/Ureaplasma infection in pregnancy: to screen or not to screen
  4. Increased rates of cesarean sections and large families: a potentially dangerous combination
  5. Original articles - Obstetrics
  6. Clinical chorioamnionitis at term VII: the amniotic fluid cellular immune response
  7. Clinical chorioamnionitis at term VIII: a rapid MMP-8 test for the identification of intra-amniotic inflammation
  8. The importance of clinically and ethically fine-tuning decision-making about cesarean delivery
  9. Use of translabial three-dimensional power Doppler ultrasound for cervical assessment before labor induction
  10. Perinatal death associated with umbilical cord prolapse
  11. YKL-40 expression in abnormal invasive placenta cases
  12. B-type natriuretic peptide and echocardiography reflect volume changes during pregnancy
  13. Original articles - Fetus
  14. Evidence-based, ethically justified counseling for fetal bilateral renal agenesis
  15. Fetal thymus size in pregnant women with diabetic diseases
  16. Birth weight discordance and adverse perinatal outcomes
  17. Original articles - Newborn
  18. Carboxyhemoglobin – the forgotten parameter of neonatal hyperbilirubinemia
  19. Growth attainment in German children born preterm, and cardiovascular risk factors in adolescence. Analysis of the population representative KiGGS data
  20. Fresh frozen plasma transfusion – a risk factor for pulmonary hemorrhage in extremely low birth weight infants?
  21. Letter to the Editor
  22. Risk factors for uterine rupture with a special interest in uterine fundal pressure: methodological issues
  23. Congress Calendar
  24. Congress Calendar
Downloaded on 31.12.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpm-2016-0294/html
Scroll to top button