The Long-term impact of intrauterine growth restriction in a diverse US cohort of children: The EPOCH study

Authors


  • Funding agencies: This study was supported by NIH grant (R01 DK06800107 to Dr. Dabelea). The study sponsor had no role in this study.

  • Disclosures: The authors declare no conflicts of interest.

  • Author contributions: TC contributed to acquisition of data, carried out the analysis, drafted the manuscript, revised the manuscript, and approved the manuscript as submitted. AS coordinated acquisition and interpretation of the MRI data and critically reviewed the article for intellectual content. ES contributed to acquisition of data and critically reviewed the article for intellectual content. RM reviewed the article for intellectual content and contributed to interpretation of the data. KB reviewed the article for intellectual content and contributed to interpretation of the data. RH critically reviewed the article for intellectual content and contributed to interpretation of the data. DD conceptualized and designed the study; critically reviewed the manuscript, and approved the final manuscript as submitted.

Abstract

Objective

To explore the long-term impact of intrauterine growth restriction (IUGR) among a diverse, contemporary cohort of US children.

Design and Methods

A retrospective cohort of 42 children exposed to IUGR and 464 unexposed who were members of Kaiser Permanente of Colorado. Height and weight measurements since birth and measures of abdominal adiposity and insulin-resistance were measured at an average age of 10.6 (±1.3) years.

Results

Infants born IUGR experienced “catch-up growth” in the first 12 months of life at a rate of 3.58 kg/m2 compared to 2.36 kg/m2 in unexposed infants (P = 0.01). However, after 1 year of age, no differences in BMI growth velocity were observed. Nevertheless children exposed to IUGR had higher waist circumference (67.0 vs. 65.3 cm, P = 0.03), higher insulin (15.2 vs. 11.0 μU/ml, P = 0.0002), higher HOMA-IR (2.8 vs. 2.3, P = 0.03), and lower adiponectin levels (9.0 vs. 12.0 μg/ml, P = 0.003) in adolescence, independent of other childhood and maternal factors.

Conclusions

Our data from a contemporary US cohort suggests that children exposed to IUGR have increased abdominal fat and increased insulin resistance biomarkers despite no differences in BMI growth patterns beyond 12 months of age. These data provide further support for the fetal programming hypothesis.

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