{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:29:33Z","timestamp":1787056173675,"version":"build-2736575974"},"reference-count":77,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,5]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neonatal size and body composition, including fat mass and fat-free mass, are influenced by maternal nutritional status, lifestyle and overall health during pregnancy. Paternal health and household factors may also be contributory to neonatal body composition and subsequent growth trajectories. Neonatal anthropometry and body composition are important predictors of early morbidity, growth faltering, stunting and childhood adiposity and long-term risk of obesity and non-communicable diseases (NCDs). In South Africa, 28% of children under 5 years are stunted, alongside a growing overweight and obesity prevalence and NCD risk in children. Limited evidence exists regarding the maternal and paternal determinants of neonatal body composition in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This prospective cohort study aims to investigate maternal and paternal nutritional, health, body composition and lifestyle factors that influence neonatal size and body composition in Bloemfontein. The study will enrol 200 mother\u2013neonate pairs at birth from Universitas Academic Hospital and follow them to 6\u2009weeks postpartum. Maternal assessments at enrolment include anthropometry, body composition (using bioimpedance analysis), dietary intake, medical history, mental health, household food security and socio-economic and lifestyle factors. Neonatal measurements include birth weight and length, gestational age and body composition (using air displacement plethysmography). Paternal data include anthropometry, body composition, dietary intake, chronic disease risk and lifestyle factors, including alcohol use and smoking. At 6\u2009weeks postpartum, infant feeding practices, growth and body composition are assessed. Multiple linear and logistic regression models will be used to assess the relationships between maternal and paternal factors and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study is approved by the Health Sciences Research Ethics Committee of the University of the Free State and the Free State Department of Health. Findings of this study will be published as scientific articles in peer-reviewed journals, presented at scientific conferences and workshops and disseminated at hospital staff forums and in local media.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121145","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:50:33Z","timestamp":1787053833000},"page":"e121145","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of neonatal size and body composition: protocol of a prospective cohort study of mother\u2013newborn pairs in Bloemfontein, South Africa"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-4520","authenticated-orcid":false,"given":"Janet Adede","family":"Carboo","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meaka","family":"Garland","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Moolman","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna May","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026081804501591000_16.8.e121145.1","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.1021901","article-title":"Developmental origins of disease highlight the immediate need for expanded access to comprehensive prenatal care","volume":"10","author":"McDonald","year":"2022","journal-title":"Front Public Health"},{"key":"2026081804501591000_16.8.e121145.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00522-6"},{"key":"2026081804501591000_16.8.e121145.3","doi-asserted-by":"publisher","DOI":"10.1177\/03000605211028026"},{"key":"2026081804501591000_16.8.e121145.4","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqac051"},{"key":"2026081804501591000_16.8.e121145.5","doi-asserted-by":"crossref","first-page":"101099","DOI":"10.1016\/j.ehb.2021.101099","article-title":"Early childhood stunting and later life outcomes: A longitudinal analysis","volume":"44","author":"Deshpande","year":"2022","journal-title":"Econ Hum Biol"},{"key":"2026081804501591000_16.8.e121145.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0192196","article-title":"Associations of stunting in early childhood with cardiometabolic risk factors in adulthood","volume":"13","author":"De Lucia Rolfe","year":"2018","journal-title":"PLoS One"},{"key":"2026081804501591000_16.8.e121145.7","doi-asserted-by":"crossref","DOI":"10.1038\/s41387-018-0056-7","article-title":"Body composition during early infancy and its relation with body composition at 4 years of age in Jimma, an Ethiopian prospective cohort study","volume":"8","author":"Admassu","year":"2018","journal-title":"Nutr Diabetes"},{"key":"2026081804501591000_16.8.e121145.8","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-0737","article-title":"Neonatal Adiposity and Childhood Obesity","volume":"146","author":"Moore","year":"2020","journal-title":"Pediatrics"},{"key":"2026081804501591000_16.8.e121145.9","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpu266"},{"key":"2026081804501591000_16.8.e121145.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002888","article-title":"Associations of fat mass and fat-free mass accretion in infancy with body composition and cardiometabolic risk markers at 5 years: The Ethiopian iABC birth cohort study","volume":"16","author":"Wibaek","year":"2019","journal-title":"PLoS Med"},{"key":"2026081804501591000_16.8.e121145.11","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1507\/endocrj.EJ25-0178","article-title":"Association between lean mass and the risk of metabolic syndrome in Korean children and adolescents: data from the Korea National Health and Nutrition Examination survey","volume":"72","author":"Park","year":"2025","journal-title":"Endocr J"},{"key":"2026081804501591000_16.8.e121145.12","unstructured":"National Department of Health, Statistics South Africa, South African Medical Research Council, ICF . 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