(1) Intrauterine growth restriction (IUGR) is associated with multiple morbidities including growth restriction and impaired neurodevelopment. Small for gestational age (SGA) is defined as a birth weight <10th percentile, regardless of the etiology. The term is commonly used as a proxy for IUGR, but it may represent a healthy constitutionally small infant. Differentiating between IUGR and constitutionally small infants is essential for the nutritional management. (2) Infants born at <37 weeks of gestation between 2017 and 2022, who underwent body composition measurement (FFM: fat-free mass; FM: fat mass) at term-equivalent age, were included in this study. Infants with IUGR and constitutionally small infants (SGA) were compared to infants appropriate for gestational age (AGA). (3) A total of 300 infants (AGA: n = 249; IUGR: n = 40; SGA: n = 11) were analyzed. FFM (p < 0.001) and weight growth velocity (p = 0.022) were significantly lower in IUGR compared to AGA infants, but equal in SGA and AGA infants. FM was not significantly different between all groups. (4) The FFM Z-score was significantly lower in IUGR compared to AGA infants (p = 0.017). Being born constitutionally small compared to AGA had no impact on growth and body composition. These data showed that early aggressive nutritional management is essential in IUGR infants to avoid impaired growth and loss of FFM.

Background: Preeclampsia is associated with intrauterine growth restriction (IUGR), which can lead to impaired postnatal growth and neurodevelopment in preterm infants. Preeclampsia can also occur without IUGR and its impact on postnatal nutrition, growth, and body composition remains not fully investigated to the best of our knowledge. Methods: This study included infants born before 37 weeks of gestation who underwent air displacement plethysmography to measure body composition (fat-free mass [FFM] and fat mass [FM]) at term-equivalent age. We compared infants born to mothers with preeclampsia and IUGR (PE-IUGR group) and preeclampsia without IUGR (PE-non-IUGR group) to those born to mothers without preeclampsia (control group). Results: In total, 291 infants were enrolled (control: n = 227; PE-non-IUGR: n = 43; PE-IUGR: n = 21). FFM was significantly lower in the PE-IUGR (mean differences −231 g (IQR: (−373, −88); p < 0.001)) and PE-non-IUGR groups (mean differences −260 g (IQR: (−372, −149); p < 0.001)) in comparison to the control group. FM was not significantly different between the three groups. Conclusions: This study indicates that infants of preeclamptic mothers, even without IUGR, had significantly lower FFM at term-equivalent age compared to the control group. Further research is necessary to determine if these variations can be modified.

Background/Objectives: Hypertensive disorders of pregnancy (HDPs) such as preeclampsia are associated with adverse maternal and perinatal outcomes and related to high soluble fms-like tyrosine kinase-1 (sFlt-1) levels and low placental growth factor (PlGF) levels. While these biomarkers are used for predicting and diagnosing preeclampsia, their impact on postnatal neonatal nutritional management, growth, and body composition is not well-established. Therefore, we aimed to evaluate the association between maternal angiogenic markers, neonatal growth, and body composition. Methods: This study represents a secondary analysis of a prospective cohort study conducted at the Medical University of Vienna. Women with HDP were included in the analysis, and infants were stratified by gestational age at birth into preterm (<37 weeks of gestation) and term (≥37 weeks of gestation) groups. Maternal angiogenic markers were routinely measured at the time when HDP was first suspected, and neonatal body composition was assessed at term-equivalent age. Results: A total of 335 infants were screened, 94 of which (preterm: n = 72; term: n = 22) were included. Higher sFlt-1/PlGF ratios were significantly correlated with lower fat-free mass (FFM) z-scores (rs = −0.408; p = 0.004), but not with fat mass (FM) z-scores (p = 0.21), weight (p = 0.19), length (p = 0.31), or head circumference z-scores (p = 0.32) in preterm infants. In a linear regression model adjusted for potential neonatal confounders, higher sFlt-1/PlGF ratios were independently and significantly associated with lower FFM in preterm infants (median: −0.10, 95% CI: −0.2, 0.00; p = 0.036). In term infants, sFlt-1/PLGF ratios were not significantly correlated with FFM (p = 0.86), FM z-scores (p = 0.41), weight (p = 0.10), length (p = 0.12), or head circumference z-scores (p = 0.2). Conclusions: These findings suggest that the sFlt-1/PLGF ratio is not only a well-established marker of HDP severity during pregnancy but may also be associated with adverse effects on body composition in preterm infants, particularly in fat-free mass (FFM).