99 IGF-I, growth and body composition in preterm infants 5 BPD: Bronchopulmonary dysplasia, IRDS: Infant respiratory stress syndrome, IVH: intraventricular hemorrhage, LOS: Late-onset sepsis; NEC: Necrotizing enterocolitis; PDA: patent ductus arteriosus, PHVD: post-hemorrhagic ventricular dilatation, PVL: periventricular leukomalacia, ROP: retinopathy of prematurity Growth and body composition At birth mean (SD) weight SDS was 0.0 (0.7) and 3 infants were growth restricted (3.4 %). Between birth and 36 weeks PMA 25 infants (28.7%) showed more than 1 SD decline in weight SDS. At 36 weeks PMA 17 infants (19.5%) were growth restricted (SDS < -1.3). Figure 2 depicts the SDS for weight, length and head circumference over time. While the SDS for weight and head circumference increased after 32 weeks PMA, the SDS for length showed a continued decline up to 36 weeks PMA. At the term equivalent age visit, infants had a mean (SD) PMA of 43.3 (2.6) weeks. The mean (SD) SDS for weight, length and head circumference at term equivalent age were -0.5 (1.0), -0.7 (1.0) and 0.5 (1.0) respectively. The mean (SD) fat free mass and percentage at the termage visit were 3301 (448) g and 79.5 (4.0) % respectively. The 17 infants who were growth restricted at 36 weeks PMA had a comparable fat free mass percentage compared to those who were not growth restricted: median (IQR) 80 (79-82) and 78 (77-82) % respectively, p 0.147. Potential critical windows for growth From birth to 4 weeks PNA, more gain in weight SDS was associated with a higher fat free mass percentage at term equivalent age. (table 3) On the contrary, more weight gain from birth to 36 weeks PMA and from 30 weeks PMA onwards, was associated with a lower fat free mass percentage at term equivalent age. (table 3) Of the potential critical windows for weight gain, the strongest predictor of fat free mass percentage at term equivalent age was the change of weight SDS from 30 weeks PMA onwards. (Table 6) More gain in weight SDS in this period was associated with more fat free mass and more fat mass, but a lower fat free mass percentage at term equivalent age. (Figure 3) Correlations between length indices and fat (free) mass at term equivalent age showed a positive trend. Likewise, correlations between head circumference and fat (free) mass at term equivalent age showed a positive trend. Nevertheless, only a few potential critical windows had a statistically significant impact on body composition at term equivalent age. (table 4 and table 5) In particular, the change in length and head circumference SDS in the first 4 weeks of life did not significantly impact fat free mass percentage. Of the potential critical windows for length, the strongest predictor of fat free mass percentage was length SDS at term equivalent age: a higher length SDS was associated with a lower fat free mass percentage. For head circumference, the change in head circumference SDS from 30 weeks PMA to term equivalent
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