The long-term impact of intrauterine growth restriction in a diverse U.S. cohort of children: the EPOCH study

OBJECTIVE: To explore the long-term impact of intrauterine growth restriction (IUGR) among a diverse, contemporary cohort of U.S. children. DESIGN AND METHODS: A retrospective cohort of 42 children exposed to IUGR and 464 unexposed who were members of Kaiser Permanente of Colorado. Height and weight measurements since birth and measures of abdominal adiposity and insulin-resistance were measured at an average age of 10.6 (±1.3) years. RESULTS: Infants born IUGR experienced ‘catch-up growth’ in the first 12 months of life at a rate of 3.58 kg/m(2) compared to 2.36 kg/m(2) in unexposed infants (p=0.01). However, after 1 year of age, no differences in BMI growth velocity were observed. Nevertheless children exposed to IUGR had higher waist circumference (67.0 vs. 65.3 cm, p=0.03), higher insulin (15.2 vs. 11.0 uU/ml, p=0.0002), higher HOMA-IR (2.8 vs. 2.3, p=0.03) and lower adiponectin levels (9.0 vs. 12.0 ug/ml, p=0.003) in adolescence, independent of other childhood and maternal factors. CONCLUSIONS: Our data from a contemporary U.S. cohort suggests that children exposed to IUGR have increased abdominal fat and increased insulin resistance biomarkers despite no differences in BMI growth patterns beyond 12 months of age. These data provide further support for the fetal programming hypothesis.