ABSTRACT
The ponderal index (PI) is evaluated in the context of its distribution within a given
population. Low PI (<10th percentile for gestational age) has been extensively studied
but not much is known about the distribution and factors associated with a high (>90th
percentile) PI among small-for-gestational-age (SGA) infants. This retrospective study
of singleton live first births from 1990 to 2007 in a Midwestern city explores factors
associated with a high PI, particularly among SGA infants. Independent variables included
exposures (none, smoke, hypertension) and maternal and infant demographic characteristics.
There were 45,453 births, 28 to 42 weeks’ gestational age, 55% Whites and 51% male.
Mean PI increased with gestational age and was highest among Hispanics and lower among
SGA infants. High PI was present in 11% of appropriate-for-gestational-age and 4%
of SGA infants. Among SGA infants, odds ratios (ORs) of high PI were higher for smoke
exposure (1.21; 95% confidence interval 0.97, 1.87) and lower for males (0.66; 0.47,
0.93). In conclusion, the distribution of PI varies by exposures and of high PI by
race/ethnicity/gender. SGA infants with high PI have relative surplus of mass, and
ostensibly, adiposity, for their frame. There is a need to use PI in exploring and
defining previously observed associations between SGA and adult-onset obesity/metabolic
syndrome.
KEYWORDS
Smoking - pregnancy - ponderal index - growth restriction - small-for-gestational-age
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Felix A OkahM.D. M.S.
Children’s Mercy Hospitals and Clinics, Department of Pediatrics
2401 Gillham Road, Kansas City, MO 64108
Email: faokah@cmh.edu
