633 - Differences in Growth and Body Composition of Infants born Preterm According to Race

Poster Number: 633
Publication Number: 633.141

Ariel A.. Salas, University of Alabama School of Medicine, Birmingham, AL, United States; Katherine E. Chetta, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Laura Lach, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Lakshmi D. Katikaneni, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Elena Itriago, Baylor College of Medicine, Houston, TX, United States; Amy B. Hair, Baylor College of Medicine, Houston, TX, United States; Alvaro Moreira, University of Texas Health Science Center San Antonio, San Antonio, TX, United States; Erynn M. Bergner, University of Oklahoma College of Medicine, Oklahoma City, OK, United States; Mohamad Elabiad, University of Tennessee health Science Center, Memphis, TN, United States; Sara E. Ramel, University of Minnesota Masonic Children's Hospital, North Oaks, MN, United States

Background: Racism in health care may lead to disparities in outcomes for preterm infants. It is unclear if these mechanisms are systemic, interpersonal, or due to other social determinants of health. A recent single-center study with a small sample size suggested that Black preterm infants have higher weight gain from birth to discharge and similar fat mass (FM) gains at discharge compared with White preterm infants.

Objective: This study aimed to determine if Black race was independently associated with differences in fat mass (FM) gains at the time of discharge in a large, multicenter cohort of very preterm infants (32 weeks of gestation or less).

Design/Methods: In this retrospective multicenter study, we analyzed growth and body composition data from very preterm infants admitted to multiple neonatal units. After merging anthropometric (birth weight, length, and gestational age at delivery and at the time of discharge) and body composition data (FM and body fat percentage) from all participating centers, we calculated weight, length, and head circumference z scores at birth and at the time of body composition assessment or hospital discharge. We also calculated FM z scores and determined weight gain velocity in g/kg/day from birth to the day of body composition measurement or hospital discharge. Using this information, we compared growth velocity rates, anthropometric z scores, and FM z scores between Black and White preterm infants.

Results: The median gestational age and birthweight for the cohort (n= 688) of very preterm infants were 29 weeks [IQR, 27-30] and 1189g [SD, 362], respectively. The study population included 47% Black preterm infants and 52% females. Birthweight and gestational age were not lower in Black preterm infants. The timing of body composition assessment differed between groups (mean difference: 5 days; p=0.04). Weight gain velocity from birth to discharge was higher among Black preterm infants in unadjusted comparisons (p=0.02). After checking for collinearity and adjusting for birthweight, gestational age, and birthweight-for-age score, we found that Black preterm infants did not have more weight gain (adjusted mean: 12.8 vs. 12.6 g/kg/day; p=0.39) or higher BF z scores (adjusted mean: 1.2 vs. 1.2; p=0.26) than White preterm infants did. The correlation between weight gain and BF z score was weak in Black (r=0.33) and White (r=0.35) preterm infants.

Conclusion(s): After adjusting for birthweight, gestational age, and weight-for-age z scores, Black race was not associated with higher weight gain velocity or BF z scores.