Weight/length ratio references and newborn body composition estimation at birth from a Brazilian cohort

Grandi, Carlos; Rodrigues, Livia dos S.; Aragon, Davi C.; Carmona, Fabio; Cardoso, Viviane C.

doi:10.1016/j.jped.2020.12.004

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ORIGINAL ARTICLE • J. Pediatr. (Rio J.) 97 (06) • 2021 • https://doi.org/10.1016/j.jped.2020.12.004 copy

Weight/length ratio references and newborn body composition estimation at birth from a Brazilian cohort^* * Study conducted at the Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

The objective was to calculate weight/length (W/L) ratio values and percentiles by sex and gestational age (GA) to estimate fat mass (FM), fat-free mass (FFM) and body fat percentage (BF%) as well as to compare these indices in preterm, small (SGA), and large (LGA) for GA, stunted and wasted infants from a Brazilian cohort of newborns, comparing with the INTERGROWTH-21st.

Methods:

Secondary, cross-sectional analysis of data obtained of 7427 live-born infants from the BRISA Cohort Study in the city of Ribeirão Preto, SP, Brazil in 2010. For body composition estimation, W/L ratio was used in multiple regression models. The 3rd, 50th, and 97th percentiles for W/L ratio and body composition measures (FM, FFM, and BF%) were calculated using fractional polynomial regression models.

Results:

Average W/L ratio was 6.50 kg/m (SD 0.87), while for FM, BF%, and FFM the corresponding values were 359.64 g (145.76), 10.90% (3.05) and 2798.84 g (414.84), respectively. SGA (< 3rd percentile), and wasted infants showed the lowest W/L ratios and measures of body composition. The 3rd, 50th, and 97th percentiles charts of W/L, FM, BF%, and FFM by GA and sex are presented.

Conclusions:

W/L ratio values of the RP-BRISA Cohort are higher than IG-21st. SGA (< 3rd) and wasted infants showed the lowest W/L ratio and measures of body composition. The body composition references presented here could be used to refine the nutritional assessment of Brazilian newborns and to facilitate comparisons across populations.

KEYWORDS
Anthropometry; Body composition; Nutrition assessment; Weight/length ratio; Fat mass

Characteristic^a a Excluded cases ignored.	Boys		Girls		Total
Characteristic^a a Excluded cases ignored.	(n = 3682)		(n = 3745)		(n = 7427)
Gestational age at delivery, w	38.27	2.11	38.39	2.00	38.33	2.06
24-27, n (%)	20	0.54	13	0.35	33	0.44
28-31	35	0.95	35	0.93	70	0.94
32-36	396	10.76	358	9.56	754	10.15
37-42	3231	88.17	3339	89.16	6570	88.46
Preterm birth (<37 w)	451	12.25	406	10.84	857	11.53
Birth Weight, g	3214	540	3105	502	3160	524
24-27 w	940	410	760	250	870	360
28-31 w	1340	540	1530	560	1440	550
32-36 w	2700	510	2570	500	2640	510
37-42 w	3310	430	3190	410	3250	420
Birth weight z-score ^{^b b Calculated for each newborn using the INTERGROWTH-21st Newborn Size Standards.}	0.10	1.01	0.06	1.01	0.08	1.01
Birth length, cm	48.65	2.75	48.03	2.55	48.34	2.67
Birth length z-score ^b b Calculated for each newborn using the INTERGROWTH-21st Newborn Size Standards.	-0.15	1.09	-0.19	1.12	-0.17	1.11
Head circumference, cm	34.54	1.98	34.08	1.89	34.31	1.95
Head circumference z-score ^b b Calculated for each newborn using the INTERGROWTH-21st Newborn Size Standards.	0.66	1.27	0.65	1.26	0.66	1.27
Weight to length ratio, kg/m	6.57	0.88	6.44	0.84	6.50	0.87
Weight to length ratio z-score	0.32	1.02	0.28	1.02	0.30	1.02
BMI, kg/m ²	13.47	1.45	13.37	1.46	13.42	1.45
Ponderal index, kg/m³	27.70	2.82	27.85	2.94	27.77	2.88
SGA, <3rd percentile	67	1.82	72	1.92	139	1.87
SGA, <10th percentile	227	6.17	260	6.94	487	6.56
LGA, >97th percentile	176	4.78	166	4.43	342	4.60
Stunting, <3rd percentile of birth length	135	3.67	190	5.07	325	4.38
Wasting, <3rd percentile of BMI	39	1.06	44	1.17	83	1.12
FGR c
Normal	3060	83.11	2806	74.93	5866	78.98
Mild	466	12.66	681	18.18	1147	15.44
Moderate	67	1.82	150	4.01	217	2.92
Severe	89	2.42	108	2.88	197	2.65
Fat mass, g	339.14	147.33	379.78	141.37	359.64	145.76
Percentage of body fat, %	10.06	2.98	11.73	2.87	10.90	3.05
Fat-free mass, g	2879.50	414.74	2729.01	393.26	2798.84	414.84

	W/L ratio, kg/m		FM, g		Percent body fat, %		Fat-free mass, g
Preterm (n = 857)	5.41	1.19	276.07	140.06	8.90	3.87	2179.21	572.38
Term (n = 6570)	6.65	0.70	378.19	126.84	11.16	2.82	2879.67	308.53
SGA <3 (n = 139)	4.65	1.10	97.64	47.13	3.77	2.55	2031.75	612.09
SGA <10 (n = 487)	5.25	0.88	158.66	65.26	5.76	2.32	2305.94	478.84
LGA >97 (n = 342)	7.78	0.90	615.25	126.02	16.52	2.51	3268.75	472.65
Stunting (n = 325)	5.56	1.27	249.93	153.96	7.41	4.12	2402.08	621.71
Wasting (n = 83)	4.94	0.67	103.25	59.44	4.34	2.04	2198.74	360.35

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br

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[1] *
Study conducted at the Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

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Weight/length ratio references and newborn body composition estimation at birth from a Brazilian cohort* * Study conducted at the Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Abstract

Objectives:

Methods:

Results:

Conclusions:

Weight/length ratio references and newborn body composition estimation at birth from a Brazilian cohort^* * Study conducted at the Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.