WIP 56 - Evaluating the impact of early growth patterns on long-term health outcomes for large for gestational age infants

Publication Number: WIP 56.7401

Emily Koos, Kaiser Permanente Pediatric Care Center, Anaheim, CA, United States; Puneet Arora, Kaiser Permanente Pediatric Care Center, Los Angeles, CA, United States; Fu-Sheng Chou, Kaiser Permanente Riverside Medical Center, Riverside, CA, United States; Seungyong Han, Kaiser Permanente, Pasadena, CA, United States; Arash Moghimi, Kaiser Permanente Pediatric Care Center, los angeles, CA, United States

Background: Large for gestational age (LGA) infants face both immediate & long-term health outcomes. Emerging evidence suggests that LGA infants may exhibit a distinct growth pattern characterized by decelerated growth in early life, also termed catch-down growth. Although initial findings hint at a protective effect of catch-down growth against long-term health complications associated with being LGA, the precise nature of this relationship and its implications for future health outcomes remain poorly defined.

Objective: This IRB-approved retrospective review the impact of growth pattern of LGA infants and its correlation to long-term metabolic outcomes and obesity.

Design/Methods: Study duration: 01/2009-12/2013
Study endpoint: 10 years of age
Change in growth defined as catch up: difference in weight-for-age z scores >.67; catch-down z scores <-.67; no catch-up/down z score -.67<= difference in weight-for-age z scores <=.67
Total LGA sample size: 18399. Excluded 8642 (missing data). Of the remaining 9757 LGA babies: 1182 were categorized to have catch-up growth, 2090 to have no catch-up or down, and 6485 had catch-down growth.
Result/Interpretations:
Obesity at 5 Years Old:
Catch-up vs Catch-down OR=12.41(10.81;14.24)
Catch-up vs No Up/Down OR=4.79(4.42;5.19)
Catch-down vs No Up/Down OR=0.38(0.33;0.45)
Obesity at 10 Years Old:
Catch-up vs Catch-down OR=3.93(3.60;4.29)
Catch-up vs No Up/Down OR=2.50(2.35;2.69)
Catch-down vs No Up/Down OR=0.64(0.58;0.70)
Catch-up growth is associated with increased odds of obesity at 5 and 10 years, with stronger association at 5 yrs. Children who experienced catch-up growth are 12 times more likely to be obese at 5 years old compared to those who had catch-down growth.
Our findings emphasize on the importance of monitoring growth patterns in early childhood to understand the potential obesity risk later in life.
We further aim to correlate these growth patterns to HbA1c, lipid profile & blood pressure in the first 10 years of life.
Timeline:
Data collection:12/2024
Data analysis/results: 2/2025
PAS presentation: 4/2025
Manuscript submission: 6/2025