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<p>This study aims to identify the optimal postnatal weight gain through age 6 to prevent obesity in preterm infants. Nested case-control study using a nationwide South Korean cohort (2008–2015) included preterm infants with obesity (cases) and those with BMI between the 5th–85th percentiles (controls) at age 6. Weight-for-age and BMI z-scores were compared using Cohen’s <i>d</i>. Logistic regression identified obesity risk factors, and net benefit analysis determined optimal intervention points by birth weight. Among 41,286 preterm infants, 3349 (8.1%) developed obesity. Birth weight z-score differences between cohorts were small (Cohen’s d = 0.115), but differences in weight-for-age z-scores emerged at 4–6 months (Cohen’s d = 0.474) and grew over time (3 years: Cohen’s d = 1.278). Risk factors included low gestational age, high birth weight, rural residence, lower socioeconomic status, and recent birth. Higher z-scores correlated with greater net benefit, with extremely low birth weight infants showing earlier increases. In conclusion, a rapid increase in z-scores from 4 to 6 months was strongly linked to obesity at 6 years. Optimal predictive values varied by birth weight, emphasizing the need for early monitoring and tailored cut-off values for z-scores based on corrected age to prevent obesity.</p>

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Optimal weight gain to reduce obesity risk in preterm infants in a National cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月10日

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  • Ga Won Jeon,
  • Jaeho Shin,
  • Eun Kyo Ha,
  • Ju Hee Kim,
  • Min Seo Kim,
  • Boeun Han,
  • Soonchul Lee,
  • Man Yong Han

摘要

This study aims to identify the optimal postnatal weight gain through age 6 to prevent obesity in preterm infants. Nested case-control study using a nationwide South Korean cohort (2008–2015) included preterm infants with obesity (cases) and those with BMI between the 5th–85th percentiles (controls) at age 6. Weight-for-age and BMI z-scores were compared using Cohen’s d. Logistic regression identified obesity risk factors, and net benefit analysis determined optimal intervention points by birth weight. Among 41,286 preterm infants, 3349 (8.1%) developed obesity. Birth weight z-score differences between cohorts were small (Cohen’s d = 0.115), but differences in weight-for-age z-scores emerged at 4–6 months (Cohen’s d = 0.474) and grew over time (3 years: Cohen’s d = 1.278). Risk factors included low gestational age, high birth weight, rural residence, lower socioeconomic status, and recent birth. Higher z-scores correlated with greater net benefit, with extremely low birth weight infants showing earlier increases. In conclusion, a rapid increase in z-scores from 4 to 6 months was strongly linked to obesity at 6 years. Optimal predictive values varied by birth weight, emphasizing the need for early monitoring and tailored cut-off values for z-scores based on corrected age to prevent obesity.