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Methodology and Mathematical Modeling

Newborn Adiposity Measured by Plethysmography Is Not Predicted by Late Gestation Two-Dimensional Ultrasound Measures of Fetal Growth^1,2

³ Center for Pediatric Nutrition Research and ⁴ Division of General Pediatrics, Department of Pediatrics, and ⁵ Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84158

Noninvasive measures of fetal and neonatal body composition may provide early identification of children at risk for obesity. Air displacement plethysmography provides a safe, precise measure of adiposity and has recently been validated in infants. Therefore, we explored relationships between term newborn percent body fat (%BF) measured by air displacement plethysmography to 2-dimensional ultrasound (2-D US) biometric measures of fetal growth and maternal and umbilical cord endocrine activity. A total of 47 mother/infant pairs were studied. Fetal biometrics by 2-D US and maternal blood samples were collected during late gestation (35 wk postmenstrual age); infants were measured within 72 h of birth. Fetal biometrics included biparietal diameter, femur length, head circumference, abdominal circumference (AC), and estimated fetal weight (EFW). Serum insulin, insulin-like growth factor (IGF) 1, IGF binding protein-3, and leptin concentrations were measured in umbilical cord and maternal serum. The mean %BF determined by plethysmography was 10.9 ± 4.8%. EFW and fetal AC had the largest correlations with newborn %BF (R² = 0.14 and 0.10, respectively; P < 0.05); however, stepwise linear regression modeling did not identify any fetal biometric parameters as a significant predictor of newborn %BF. Newborn mid-thigh circumference (MTC; cm) and ponderal index (PI; weight, kg/length, cm³) explained 21.8 and 14.4% of the variability in %BF, respectively, and gave the best stepwise linear regression model (%BF = 0.446 MTC + 0.347 PI –29.692; P < 0.001). We conclude that fetal growth biometrics determined by 2-D US do not provide a reliable assessment of %BF in term infants.

^* To whom correspondence should be addressed. E-mail: laurie.moyer-mileur{at}hsc.utah.edu.

Manuscript received 21 April 2009. Initial review completed 25 May 2009. Revision accepted 10 July 2009.

Published online 29 July 2009.