Correction
13 Feb 2024: The PLOS ONE Staff (2024) Correction: Correction: Accelerated weight gain, prematurity, and the risk of childhood obesity: A meta-analysis and systematic review. PLOS ONE 19(2): e0299066. https://doi.org/10.1371/journal.pone.0299066 View correction
Figures
After this article [1] was published, the authors identified errors in Fig 3. In Fig 3B, the x-axis labels “Favors preterm SGA” and “Favors preterm AGA” are swapped. The left label should be “Favors preterm AGA” and the right label should be “Favors preterm SGA”. Also in Fig 3B, there is an error in the reported aOR (95% CI) for Gaskin 2010. This error also resulted in incorrect % weight values, the I-squared statistic and p value, and aOR (95% CI) overall. The authors provide a corrected Fig 3 here. In the second sentence of the Research question 2 subsection of the Results, the correct sentence is: “The result of meta-analysis revealed no significant difference on childhood obesity between SGA and AGA infants (adjusted OR = 1.03; 95% CI [0.69, 1.53]; p = 0.107; Fig 3B)”
(A) Association between preterm status and childhood obesity (B) Association between preterm SGA (vs. preterm AGA) and childhood obesity (C) Association between accelerated weight gain and childhood obesity (D) Association between childhood fat mass index and preterm status.
In addition, after publication of this article [1], concerns were raised about the use of the term “impact”, as this incorrectly implies a causal relationship. Therefore, “impact of…on” is corrected throughout the article to “association between…and”.
The authors apologize for the errors in the published article, which do not affect the Conclusions.
Some concerns were also raised about possible biases in the statistical analyses.
Concerns were raised that confounding effects may have introduced bias and may not have been adequately discussed. The authors provide additional information to Table 1 here about the covariates/confounders that were adjusted and reported in each original study selected.
Concerns were also raised about the lack of sensitivity analyses included in the study. The authors provide an additional S1 Table to summarize the sensitivity analysis using the “leave-one-out” approach, below. The authors provide the following clarifications discussing the results of the sensitivity analysis, which does not affect the original conclusions.
It was noted that in the meta-analysis assessing the association between preterm status and childhood obesity (Fig 3A), one study (Mardones et al. 2008) [2] contributed 97% of the data. The authors clarify here that during the sensitivity analysis, as shown in S1 Table, the pooled estimate shifted to non-significant (OR = 1.213, 95%CI: 0.884, 1.663, p = 0.232) upon excluding Mardones et al. (S1 Table). Accordingly, readers are advised to exercise caution when interpreting the conclusion of this meta-analysis on the difference between preterm vs term infants in association with childhood obesity, as the pooled estimate is substantially influenced by the study of Mardones et al.
It was also noted that in the meta-analysis assessing the association between preterm SGA (vs. AGA) and childhood obesity (Fig 3B), one study (Ramírez-Vélez et al.) [3] that controls for later weight contributed the most data to the pooled estimate. The authors clarify here that during the sensitivity analysis, as shown in S1 Table, the pooled estimate remained similar to the original estimate (OR = 0.932, 95%CI: 0.416; 2.089, p = 0.865) upon excluding Ramírez-Vélez et al., suggesting the meta-analysis outcome is robust (S1 Table).
Finally, it was noted there was a high degree of heterogeneity among the included estimates for the meta-analysis assessing the association between accelerated weight gain and childhood obesity (Fig 3C). The authors clarify here that during the sensitivity analysis, as shown in S1 Table, the heterogeneity reduced upon excluding the study by Vohr et al. [4]. In Fig 3D, substantial heterogeneity was also noted across the studies. Yet, upon excluding individual studies during sensitivity analysis, there was no reduction in the observed heterogeneity (S1 Table).
Concerns were also raised that seven studies that report BMIs of both preterm and term-born children [5–11] were excluded from the meta-analysis comparing childhood obesity risk between preterm and term infant (Fig 3A), without sufficient justification. The authors clarify here that these studies were excluded from analysis due to specific reasons. Forsum et al. (2019) [5] only presented data comparing BMI between full-term boys and girls, lacking a comparison of childhood obesity status between preterm and term-born infants. Other studies [6–11] either reported BMI data in continuous values or presented z-scores incompatible with studies using dichotomized obesity status in the present meta-analysis. The authors wish to clarify that the criterion of childhood obesity (i.e., age and sex-specific BMI > = 95th percentile) was chosen based on its frequent usage in the included articles. This approach was specifically selected to mitigate potential confounding effects related to age and gender when studying pediatric BMI.
In addition, the authors clarify that no test for publication bias was performed since none of the meta-analyses performed included ten or more studies.
A member of the Editorial Board reviewed the article and concerns raised, and advised that additional information and clarifications to the statistical analyses were required to support the study conclusions. A member of the Statistical Advisory Group reviewed the article and concerns raised, and advised that the corrections and clarifications above address the concerns and support the results and conclusions reported in the article; they confirmed that following sensitivity analysis, the original findings still stand.
References
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Citation: Ou-Yang M-C, Sun Y, Liebowitz M, Chen C-C, Fang M-L, Dai W, et al. (2024) Correction: Accelerated weight gain, prematurity, and the risk of childhood obesity: A meta-analysis and systematic review. PLoS ONE 19(2): e0298556. https://doi.org/10.1371/journal.pone.0298556
Published: February 5, 2024
Copyright: © 2024 Ou-Yang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.