278 - Protective Perinatal Factors Against Rapid Infant Weight Gain in a Cohort of Predominantly Latinx Premature Infants

Publication Number: 278.6360

Eisha Jain, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Janet M.. Wojcicki, University of California, San Francisco, School of Medicine, San Francisco, CA, United States

Background: Childhood obesity is a growing epidemic linked to the early onset of debilitating chronic diseases. Prematurity is a known physiologic risk factor for childhood obesity. While existing literature identifies risk factors for childhood obesity in the general population, little is known about factors influencing risk for childhood obesity in premature infants.

Objective: This study aims to identify perinatal risk and protective factors for childhood obesity in a cohort of premature infants ( < 37 weeks gestation).

Design/Methods: This is a retrospective study of 55 premature infants born at UCSF Benioff Children’s Hospital and Zuckerberg San Francisco General Hospital from 2016 to 2023. Data collected from EPIC chart review included maternal, delivery, and newborn data from the labor and delivery admission, surveyed feeding data from the first 6 months of life, and weight data through the first year of life. Using R statistical software, logistic and linear regression analyses were performed to assess possible associations between perinatal risk factors and rapid infant weight gain (RIWG), defined as weight-for-age (WFA) z-score change of at least 0.67 from birth to 1 year age. Statistical significance was defined as p< 0.05. Mothers provided signed written consent for their own and their children’s participation, and UCSF IRB approved the study.

Results: Mean gestational age and mean birthweight of the study cohort were 35.2 weeks (SD 1.47) and 2.51kg (SD 0.52kg), respectively. 38% of newborns were female, 82% had at least one parent self-reported as Latinx, and 56% had RIWG in the first year of life. Exclusive breastfeeding at the time of newborn discharge protected against RIWG in this population, reducing risk of RIWG by 72% (OR 0.28, p=0.03). Higher maternal self-reported frequency of juice consumption (cups/week) during pregnancy predicted higher change in WFA z-score from birth to 1 year age (OR 0.09, p=0.03). Other perinatal risk factors, including maternal pre-pregnancy BMI, maternal weight gain during pregnancy, maternal ethnicity, and age at introduction of solids were not significantly associated with RIWG in this study.

Conclusion(s): Our findings suggest that exclusive breastfeeding early in infancy may protect against RIWG in premature infants. Promotion of exclusive breastfeeding in late preterm infants may help attenuate the higher physiologic risk for childhood obesity and associated health complications in this population subgroup.