Associations between prenatal and postnatal growth and adult body size and composition

Background: Adult body size and composition (ABSC) measures are associated with work capacity and productivity, reproductive performance, and chronic disease risk. Growth failure in early childhood may have important long-term consequences through its influence on ABSC. Objective: We assessed associations between prenatal and postnatal growth (0-2 y of age) and ABSC. Design: We included 267 singletons from a prospective study carried oat between 1969 and 1977 in 4 ladino Guatemalan villages. We used data from that study and from a follow-up study conducted in 1998-1999 (when the subjects were 21-27 y of age) to determine associations of birth weight, length at 15 d of age, ponderal index, and length at 2 y of age with adult height, weight, fat-free mass (FFM), fat mass, percentage of body fat, and waist-to-hip ratio. Multivariate linear regression analyses with mixed models were carried out to account for sibling clustering. Two-stage least-squares analyses were used to separate specific effects of prenatal and postnatal growth. Results: Birth weight, length at 15 d of age, and length at 2 y of age were positively associated with height, weight, and FFM in both sexes (P < 0.05). Prenatal growth and postnatal growth were equally important determinants of height, weight, and FFM. Weak positive associations of postnatal growth with adult fat mass and percentage of body fat were found in both sexes, whereas similar associations for prenatal growth were found in women only. Growth in early childhood was not related to waist-to-hip ratio. Conclusions: Growth retardation in early childhood was associated with shortness and less FFM in adulthood. Preventing growth failure in utero and preventing growth failure during the first 2 y of life are equally important for ABSC.