Growth of children living in the outskirts of Ankara: impact of low socio-economic status

BACKGROUND: Most studies of the growth of Turkish schoolchildren are limited to large cities and to subjects from high socio-economic background. Very little is known about growth and development of rural, suburban and low socio-economic children in Turkey. AIM: The purpose of this study is to compare height and weight of school-aged children of low socio-economic background with available growth data from high socio-economic strata, and to verify the possible influences of three socio-demographic parameters on their growth. SUBJECTS AND METHODS: The sample consisted of 1,052 girls and 1,223 boys, aged between 7-17 years, living in the outskirts of Ankara, a suburban area of poor socio-economic background. Centile distributions for height and weight were estimated by the LMS-method. ANOVA and Student's t-test were used to compare mean z-scores for height and weight among the various categories of the socio-demographic parameters. RESULTS: Children living in the outskirts of Ankara have lower mean values for height and weight when compared with growth data of upper socio-economic strata children. The differences were most pronounced during adolescence. Skinfolds were higher in girls than in boys at all ages (largest p = 0.007). There was no clear relationship between growth and the number of siblings, the number of rooms in the house, the mother's and father's education, and the father's professional status (p > 0.05), except for the height of girls (p < 0.05). CONCLUSION: It is suggested that the lower growth status of children living in the outskirts of Ankara is attributable to the poor socio-economic status of this suburban population, which has not changed over the past decades. It is postulated that the growth impairment during adolescence might be due to a reduced tempo of growth in these children.     

Differences in development and the prevalence of obesity among children and adolescents in different socioeconomic status districts in Shandong,China

Background: There are wide-ranging differences in human growth, not only between ethnic groups but also between regions. Shandong is one of the most populous provinces in China, with inequalities of regional economic status. However, no studies on the differences in development among children and adolescents in different districts have been reported.

Aim: This study assessed the differences in height, weight and prevalence of obesity among children and adolescents of different socioeconomic status (SES) districts in Shandong, China.

Subjects and methods: Data for this study were obtained from a large cross-sectional survey of schoolchildren. A total of 42 286 students (21 222 boys and 21 064 girls) aged 7–18 years from 16 districts participated in this study. Height and weight of all subjects were measured and BMI was calculated from their height and weight. Prevalence rates of obesity and overweight were determined by comparing calculated BMIs (kg/m²) to International Obesity Task Force (IOTF) cut-offs. Each of the 16 districts was assigned an SES ranking (low, moderate, high) based on per capita GDP and income in urban and rural areas. Comparisons of height, weight and the prevalence of overweight and obesity among different groups were made.

Results: Significant differences between SES groups were observed for height, weight and the prevalence of overweight and obesity. Boys and girls from high SES group were taller, heavier and more likely to be obese than their peers from moderate and low SES groups. The prevalences of combined overweight and obesity in the three SES groups were 18.46%, 21.08% and 27.31% in boys and 10.43%, 12.42% and 15.18% in girls, respectively.

Conclusion: There have been obvious regional variations in development and the prevalence of obesity in children and adolescents in Shandong, China, These variations in development and prevalence of obesity in children and adolescents among different SES districts being related to the local SES, process of urbanization, living environments, nutritional status, dietary pattern, physical activity and public health.     

Effect of anthropometric characteristics and socio-economic status on physical performances of pre-pubertal children living in Bolivia at low altitude

We have previously observed that 11-year-old children of low socio-economic status (LSES) showed a delayed physical growth of approximately 2 years and developed lower normalized short-term power output than children of high socio-economic status (HSES) of the same age. In contrast, maximal oxygen uptake per unit of fat free mass was no different in either group. The aim of this study was to evaluate the effect of anthropometric characteristics between HSES and LSES prepubertal children in aerobic and anaerobic performance. To compare children of the same body dimensions, 11-year-old boys (n = 30) and girls (n = 31) of LSES and 9-year-old boys (n = 21) and girls (n = 27) of HSES were studied. Anthropometric measurements, (direct test), maximal anaerobic power (P _max, force-velocity test) and mean anaerobic power ( , Wingate test) were determined. In these children having the same body dimensions: mean were the same in LSES and HSES children [1.2 (SD 0.2)1-min^–1];P _max and were lower in LSES subjects [154.0 (SD 33.2) vs 174.6 (SD 38.4) W and 116.3 (SD 23.3) vs 128.2 (SD 28.0) W, respectively]; the linear relationships between and fat free mass were the same in LSES and HSES boys but, in the girls, the LSES group had lower values. For anaerobic performance, the relationships were significantly different: the slopes were the same but LSES values for the both sexes were lower. These results would suggest that factors other than differences in body dimensions alone were responsible for the lower performance of LSES girls and boys. Cultural factors and motor learning, structural and functional alterations of muscle induced by marginal malnutrition have been discussed.     

Investigating payment coping mechanisms used for the treatment of uncomplicated malaria to different socio-economic groups in Nigeria

BackgroundGiven the enormous economic burden of malaria in Nigeria and in sub-Saharan Africa, it is important to determine how different population groups cope with payment for malaria treatment. This paper provides new information about the differences in household coping mechanisms for expenditures on malaria treatment.MethodsThe study was undertaken in two communities in Southeast Nigeria. A total of 200 exit interviews were conducted with patients and their care givers after consultation and treatment for malaria. The methods that were used to cope with payments for malaria treatment expenditures were determined. The coping mechanisms were disaggregated by socio-economic status (SES).ResultsThe average expenditure to treat malaria was $22.9, which was all incurred through out-of- pocket payments. Some households used more than one coping method but none reported using health insurance. It was found that use of household savings (79.5%) followed by reduction in other household expenses (22.5%) were the most common coping methods. The reduction of other household expenses was significantly more prevalent with the average (Q4) SES group (p<0.05). .ConclusionPeople used different coping strategies to take care of their malaria expenditures, which are mostly paid out-of-pocket. The average socio-economic household had to forego other basic household expenditures in order to cope with malaria illness; otherwise there were no other significant differences in the coping mechanisms across the different SES groups. This could be indicative of the catastrophic nature of malaria treatment expenditures. Interventions that will reduce the burden of malaria expenditures on all households, within the context of Universal Health Coverage are needed so as to decrease the economic burden of malaria on households.     

Assessment of vitamin D status in healthy children and adolescents living in Tehran and its relation to iPTH,gender, weight and height

Abstract

This study was conducted to determine the frequency of vitamin D deficiency and its correlation with different factors. Three hundred and thirteen healthy children and adolescents (192 females and 121 males aged 8–18 years, mean ± SD, 12.7 ± 2.3 years) were enrolled, and measurements of serum 25-hydroxyvitamin D [25(OH)D] (using EIA) and intact parathyroid hormone (iPTH) (using immunoradiometric assay (IRMA)) were conducted. The grades of vitamin D status were defined according to blood level of 25(OH)D as follows: severely deficient < 12.5; deficient, ≥ 12.5 and < 25; insufficient, ≥ 25 and < 50; normal ≥ 50 and < 250 nmol/L. Severe deficiency was detected in 25% of subjects (males 8%; females 92%), deficiency in 27% (males 34%; females 66%) and insufficiency in 26% (males 58%; females 42%). The mean 25(OH)D level in males was significantly greater than that in females (p < 0.001), and this level was significantly higher in prepubertal compared to pubertal subjects (p < 0.001). 25(OH)D had a negative correlation with iPTH (p < 0.001). The curve of iPTH began to rise when 25(OH)D reached 75 nmol/L. The level of 25(OH)D had a negative correlation with BMI-SDS and height-SDS in females (p-value, 0.01 and 0.039, respectively). The subjects did not have any signs or symptoms of rickets. Frequency of vitamin D deficiency did not have any significant seasonal variation. Furthermore, vitamin D deficiency was not found to be related to the type or location of the subjects' homes. In this study, subclinical vitamin D deficiency was significantly more prevalent in females, particularly those undergoing puberty. Children who were obese and taller than average, had lower levels of 25(OH)D, and level of 25(OH)D should be maintained > 75 nmol/L in order to prevent PTH rising.     

Modernization in Bali,Indonesia and the influence of socio-economic factors on the nutritional status of preschool children in 1989/1990: An anthropometric study

Background: Bali has undergone rapid economic modernization over the past 30 years, however, very few anthropometric studies have examined the impact of modernization variables on the nutritional status of Balinese children.

Aim: The study examined the relationships between variables associated with the modernization process on the nutritional status of Balinese children in 1989/1990, as assessed by anthropometrics.

Subjects and methods: The mean height-for-age, weight-for-height and weight-for-age of 691 preschool children from nine localities across Bali were reported by age group and gender and related to the degree of modernization (using such parameters as household wealth and education level of the mother) and other variables such as the age, weight and height of the mother.

Results: Using the CDC/WHO 1978 growth references (Dibley et al. 1978), overall 35% of children were stunted (height-for-age <?2?SD), 22% were underweight (weight-for-age <?2?SD), 5% were wasted (weight-for-height <?2?SD) and 6% were overweight (weight-for-height >2?SD). The nutritional status of infants was significantly better than that of older children with growth faltering most evident during the second year of life. Maternal height and weight, the age of the child and wealth index were significantly associated with height-for-age of children, while the age of the child, maternal weight and family size were significantly associated with weight-for-height and weight-for-age of children.

Conclusions: Maternal height and weight, wealth index and the age of the child were key factors influencing the body size for age of Balinese children. The strong association between maternal and child nutritional status was most likely due to environmental rather than genetic factors.     

Contemporary height,weight and body mass index references for children aged 0 to adulthood in Switzerland compared to the Prader reference,WHO and neighbouring countries*

Abstract

Background: In 2011, WHO growth curves replaced those of Prader and colleagues (First Zurich longitudinal study) in Switzerland.

Aim: To present contemporary height-, weight- and body mass index (BMI)-for-age references reflecting children’s growth in modern Switzerland.

Subjects and methods: Cross-sectional sample comprising 30,141 boys and girls aged 0–20?years measured between 2012 and 2019. Height, weight and BMI reference curves were created using the LMS method. Derived percentiles were compared with those of Prader, WHO and neighbouring countries.

Results: Growth in the first 5?years is almost identical with Prader curves. Thereafter children are taller, yet their final height is only about 1?cm higher. Today’s children, in particular boys, are considerably heavier. In comparison with WHO growth references, Swiss children are taller from the second year until adulthood; the WHO 3rd percentiles lie about 4?cm below those of our updated references. Weight and BMI median percentiles from our sample are similar to those of WHO and higher than the Prader curves. However, the course of the 97th BMI percentile WHO curves extends well below the 97th percentile of the updated Swiss curves.

Conclusion: This study provides contemporary reference data for assessing individual growth based on height, weight and BMI of Swiss children.     

Body image,body dissatisfaction and weight status in children from Emilia-Romagna (Italy): comparison between immigrant and native-born

Background: Cross-sectional study among immigrant and native children from Emilia-Romagna (Italy).

Aim: The purpose of the present study was to examine the relative contribution of weight status, ethnicity and sex on body dissatisfaction in a sample of children from Emilia-Romagna (Italy).

Subjects and methods: Primary school children (226 immigrants and 1206 Italians) aged 6–11 years were measured: immigrant children were divided into Asians, Africans, Latin Americans and East Europeans. Height and weight were measured and Body Mass Index (BMI) was calculated. Body image perception was assessed using Body Silhouette Charts. A body dissatisfaction score (BDS) was derived by subtracting the "ideal self" from the "self" score.

Results: Weight status disorders were higher in immigrants than in native-born males; Italian females had higher prevalence of underweight and overweight and lower prevalence of obesity than immigrants peers. BDS rose with the increase of weight status categories.

Conclusions: Awareness of body image size and increasing body dissatisfaction with higher weight status is established in childhood, regardless of ethnicity and gender.     

Suicidal behaviours in South East London: Prevalence,risk factors and the role of socio-economic status

Background

Low socio-economic status (SES) is an established risk factor of suicidal behaviours, but it is unknown to what extent its association is direct, indirect or confounded, given its strong association to mental health. We aimed to (I) estimate the prevalence of suicidal behaviours; (II) describe relevant risk factors; and (III) investigate direct and indirect effects of SES on suicidal behaviours.

Methods

We used cross-sectional community survey data of adults from randomly selected South East London households (SELCoH). Suicidal outcome measures replicated the 2007 Adult Psychiatric Morbidity Survey in England (APMS). Lifetime prevalence was described by socio-demographics, SES, mental health indicators, and life events. Structured symptom screens and a drug use questionnaire measured mental health. Structural equation models estimated direct and indirect effects of a latent SES variable on suicidal ideation and suicide attempts, adjusting for covariates.

Results

20.5% (95% CI: 18.4–22.7) reported suicidal ideation and 8.1% (95% CI: 6.8–9.7) reported suicide attempts (higher than APMS estimates: 13.7%, 4.8%, respectively). Unadjusted risk factors included poor mental health, low SES, and non-married/non-cohabitating relationship status. Black African ethnicity was protective, and women reported more suicide attempts. SES was directly associated to suicide attempts, but not suicidal ideation. SES had indirect effects on suicidal outcomes via mental health and life events.

Limitations

The cross-sectional design and application of measures for different time periods did not allow for causal inferences.

Conclusions

Suicidal behaviours were more prevalent than in the general UK population. Interventions targeting low SES individuals may prove effective in preventing suicide attempts.     

Nutritional therapy improves growth and protein status of children with a urea cycle enzyme defect

BACKGROUND: Poor growth has been described in patients with urea cycle enzyme defects treated with protein-restricted diets, while protein status is seldom reported. OBJECTIVE: To assess the effects of nutritional therapy with a medical food on growth and protein status of patients with a urea cycle enzyme defect. METHODS: A 6-mo multicenter outpatient study was conducted with infants and toddlers managed by nutrition therapy with Cyclinex-1 Amino Acid-Modified Medical Food with Iron (Ross Products Division, Abbott Laboratories, Columbus, OH). Main outcome variables were anthropometrics and plasma amino acids (selected), albumin, and transthyretin concentrations. RESULTS: Seventeen patients completed the study. Mean (+/-SE) baseline age was 11.30+/-3.20 months (median 4.40 months; range 0.22-38.84 months). Length and weight z-scores increased significantly during the 6-month study. Head circumference increased, but not significantly. Three patients were stunted and two were wasted (-2.0 z-score) at baseline while at study end, only one patient was both stunted and wasted. The majority of patients increased in length, head circumference, and weight z-scores during study. Mean (+/-SE) plasma albumin concentration increased from 34+/-2g/L at baseline to 38+/-1g/L at study end. Plasma transthyretin increased from a mean (+/-SE) of 177+/-13 mg/L at baseline to 231+/-15 mg/L at study end. No correlation was found between plasma NH(3) concentrations and medical food intake. Plasma NH(3) concentration was positively correlated with the percentage of Food and Agriculture Organization/World Health Organization/United Nations recommended protein ingested. CONCLUSIONS: Intakes of adequate protein and energy for age result in anabolism and linear growth without increasing plasma NH(3) concentrations. Medical food intakes did not correlate with plasma NH(3) concentrations.     

Skeletal maturity and socio-economic status in Portuguese children and youths: the Madeira growth study

Background: Skeletal maturity is used to evaluate biological maturity status. Information about the association between socio-economic status (SES) and skeletal maturity is limited in Portugal.

Aims: The aim of this study is to document the skeletal maturity of youths in Madeira and to evaluate variation in maturity associated with SES.

Subjects and methods: The study involved 507 subjects (256 boys and 251 girls) from the Madeira Growth Study, a mixed-longitudinal study of five cohorts (8, 10, 12, 14 and 16 years of age) followed at yearly intervals over 3 years (1996–1998). A total of 1493 observations were made. Skeletal age was estimated from radiographs of the hand and wrist using the Tanner–Whitehouse 2 method (TW2). Social class rankings were based on Graffar's (1956) method. Five social rankings were subsequently grouped into three SES categories: high, average and low.

Results: Median for the radius, ulna and short finger bones (RUS scores) in the total sample of boys and girls increased curvilinearly across age whereas median for the 7 (without pisiform) carpal bones (Carpal scores) increased almost linearly. The 20-bone maturity scores demonstrated distinctive trends by gender: the medians for boys increased almost linearly while the medians for girls increased curvilinearly. SES differences were minimal. Only among children aged 10–11 years were high SES boys and girls advanced in skeletal maturity. Madeira adolescents were advanced in skeletal maturity compared with Belgian reference values.

Conclusion: The data suggests population variation in TW2 estimates of skeletal maturation. Skeletal maturity was not related to SES in youths from Madeira.     

Growth patterns and secular trends over four decades in the dynamics of height growth of Indian boys and girls in Sri Aurobindo Ashram: A cohort study

Background:?Growth parameters are widely used in the assessment of health, nutrition and physical characteristics of a population; however, there still exist uncertainties regarding ethnic variation and the influence of physical activity on growth. Due to the paucity of longitudinal data, the dynamics of the adolescent growth spurt have not been satisfactorily examined in most populations.

Aim:?The main purpose of this longitudinal study is to present the secular trends in the dynamics of height growth over four decades. In the process, this paper also aims to establish current norms for some biological parameters of growth and to address issues concerning ethnic variation and the effect of childhood physical activity on growth.

Methodology:?Three hundred and one boys and 235 girls of Indian origin who had been enrolled in the Sri Aurobindo International Centre of Education (SAICE) by age 6 and remained for at least 3 uninterrupted years were divided into four birth cohort periods. Cross-sectional and longitudinal analyses were carried out to derive distance, velocity and acceleration curves.

Results:?No significant differences were found between ethnic groups in any of the growth parameters. Over the 40-year span of this study, SAICE children prove to be taller than their Indian peers. A significant positive secular trend was seen in the height attained at all velocity turning points over the first two decades. Most pre-pubertal growth parameters in these children resemble those from developed nations.

Conclusions:?Children from most parts of India have similar genetic growth potential. After a significant positive secular trend in height attained over the first 20 years, the adult height has now plateaued. The significant difference in post-pubertal stature between the current generation and those of European origin indicates a genetic difference. Regular and graded physical activities have a salutary effect on growth. The data provide norms for healthy, active Indian child growing up in a satisfactory environment.     

Skeletal maturity and socio-economic status in Portuguese children and youths: the Madeira growth study

BACKGROUND: Skeletal maturity is used to evaluate biological maturity status. Information about the association between socio-economic status (SES) and skeletal maturity is limited in Portugal. AIMS: The aim of this study is to document the skeletal maturity of youths in Madeira and to evaluate variation in maturity associated with SES. SUBJECTS AND METHODS: The study involved 507 subjects (256 boys and 251 girls) from the Madeira Growth Study, a mixed-longitudinal study of five cohorts (8, 10, 12, 14 and 16 years of age) followed at yearly intervals over 3 years (1996-1998). A total of 1493 observations were made. Skeletal age was estimated from radiographs of the hand and wrist using the Tanner-Whitehouse 2 method (TW2). Social class rankings were based on method. Five social rankings were subsequently grouped into three SES categories: high, average and low. RESULTS: Median for the radius, ulna and short finger bones (RUS scores) in the total sample of boys and girls increased curvilinearly across age whereas median for the 7 (without pisiform) carpal bones (Carpal scores) increased almost linearly. The 20-bone maturity scores demonstrated distinctive trends by gender: the medians for boys increased almost linearly while the medians for girls increased curvilinearly. SES differences were minimal. Only among children aged 10-11 years were high SES boys and girls advanced in skeletal maturity. Madeira adolescents were advanced in skeletal maturity compared with Belgian reference values. CONCLUSION: The data suggests population variation in TW2 estimates of skeletal maturation. Skeletal maturity was not related to SES in youths from Madeira.     

Area-based socioeconomic status and mood disorders: cross-sectional evidence from a cohort of randomly selected adult women

Objective

Data suggest there are established socio-economic disparities associated with mental health although most research has focused on individual-level indicators of socio-economic position. The aim of this study was to investigate the association between mood disorders and area-based socio-economic status (SES), and whether both ends of the SES continuum experienced increased odds for a mood disorder.

Methods

Using a clinical interview (SCID-I/NP), psychiatric history was ascertained in a population-based sample of 1095 women (20–93 years) from the Barwon Statistical Division, south-eastern Australia. SES was determined by cross-referencing residential addresses with Australian Bureau of Statistics 2006 census data for the region and categorised into three groupings of low, mid, and upper SES. The Index of Economic Resources (IER), Index of Education and Occupation (IEO), and Index of Relative Socioeconomic Advantage/Disadvantage (IRSAD) were utilised. Lifestyle factors were self-reported.

Results

For IER, the low SES group had a 2.0-fold increased odds of a current mood disorder compared to the mid group, after adjustment for physical activity and current anxiety (OR = 2.0, 95% CI 1.0–4.1, p = 0.05). This pattern was similarly observed for IEO (OR = 1.8, 95% CI 0.9–3.7, p = 0.1) and IRSAD (OR = 1.6 95% CI 0.8–3.4, p = 0.2). Those within the upper SES group showed a non-significant increase in the odds of a current mood disorder compared to the mid-group; IER (OR = 1.4, 95% CI 0.8–2.5, p = 0.3), IEO (OR = 1.2, 95% CI 0.07–2.3, p = 0.5) and IRSAD (OR = 1.2, 95% CI 0.7–2.1, p = 0.6).

Conclusions

Women in the low SES category were most likely to have a mood disorder. Furthermore, being in an upper SES group may not be protective against mood disorders.     

A comparison of the merits of using birth weight,or appropriateness of birth weight to gestational age,in the assessment of subsequent growth in twin children

Background: Size at birth has an important relationship to subsequent growth. Many reports subgroup subjects according to birth weight or birth weight in relation to the duration of gestation, and it is not clear whether one of these methods is more relevant to subsequent growth or if in fact they are comparable.

Aim: The present study compared the outcome of twins in terms of pre-pubertal weight and height when sub-grouped according to birth weight (BW), or the appropriateness of birth weight for the duration of gestation (BW-SDS).

Subjects and methods: The birth weights of 1533 twins were graded into four subgroups according to BW or BW-SDS. The relationship of birth weight to subsequent weight and height standard deviation scores, obtained between the ages of 2 and 9 years, were compared on the basis of these two methods.

Results: There was a marked difference in identity of the twins who fell into each of the four subgroups by the two methods. Despite this, no difference was found in the subsequent weight and height of the twins.

Conclusions: Analysis of data relating BW-SDS to subsequent growth shows no significant difference to those groups using BW alone.     

Sensitive parenting as a cross-cultural ideal: sensitivity beliefs of Dutch,Moroccan, and Turkish mothers in the Netherlands

The primary goal of this study is to test the hypothesis that beliefs about the ideal sensitive mother are similar across Dutch, Moroccan, and Turkish mothers living in the Netherlands. A total of 75 mothers with at least one child between the ages of six months and six years described their views about the ideal sensitive mother using the Maternal Behavior Q-Sort (Pederson, Moran, & Bento, 1999 Pederson, D.R., Moran, G. and Bento, S. 1999. Manual Maternal Behavior Q-Sort Version 3.1 Retrieved from http://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1000&context=psychologypub&sei-redir=1&referer=http%3A%2F%2Fwww.google.co.uk%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Dmbqs%2520manual%2520moran%26source%3Dweb%26cd%3D2% 26ved%3D0CCYQFjAB%26url%3Dhttp%253A%252F%252Fir.lib.uwo.ca%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1000%2526context%253Dpsychologypub%26ei%3D1_VjUJXLDNOP4gS_64GIDw%26usg%3DAFQjCNGrDNIwMuiK_xxi4ipoA0SmaTW0Rw#search=%22mbqs%20manual%20moran%22 [Google Scholar]). These views were highly similar within and across cultural and socio-economic groups. Nevertheless, family income fully mediated the relationship between ethnic background and sensitivity beliefs; income of minority mothers was lower which was in turn predictive of a lower sensitivity belief score. Our findings suggest that the main behavioral markers of sensitivity are valued by mothers from different cultural backgrounds. The role of socio-economic status in sensitivity beliefs is consistent with the Family Stress Model.     

极低体重儿早期营养干预疗效分析

目的早期积极规范的营养干预对极低体重儿的益处。方法观察组20例，出生后48h静脉营养和采用早期建立肠内营养（早期微量喂养、非营养性吸吮、温盐水灌肠）；对照组15例，积极补液和消化道自然复活苏方法。结果观察组体重增长、住院天数较对照组差异有极显著意义（P＜0．01）。胎粪排尽时间、住院费用差异显著（P＜0．05）。结论早期营养干预是极低体重儿管理中行之有效综合措施。     

Application of Machine Learning Approaches to Predict Postnatal Growth Failure in Very Low Birth Weight Infants

PurposeThe aims of the study were to develop and evaluate a machine learning model with which to predict postnatal growth failure (PGF) among very low birth weight (VLBW) infants.Materials and MethodsOf 10425 VLBW infants registered in the Korean Neonatal Network between 2013 and 2017, 7954 infants were included. PGF was defined as a decrease in Z score >1.28 at discharge, compared to that at birth. Six metrics [area under the receiver operating characteristic curve (AUROC), accuracy, precision, sensitivity, specificity, and F1 score] were obtained at five time points (at birth, 7 days, 14 days, 28 days after birth, and at discharge). Machine learning models were built using four different techniques [extreme gradient boosting (XGB), random forest, support vector machine, and convolutional neural network] to compare against the conventional multiple logistic regression (MLR) model.ResultsThe XGB algorithm showed the best performance with all six metrics across the board. When compared with MLR, XGB showed a significantly higher AUROC (p=0.03) for Day 7, which was the primary performance metric. Using optimal cut-off points, for Day 7, XGB still showed better performances in terms of AUROC (0.74), accuracy (0.68), and F1 score (0.67). AUROC values seemed to increase slightly from birth to 7 days after birth with significance, almost reaching a plateau after 7 days after birth.ConclusionWe have shown the possibility of predicting PGF through machine learning algorithms, especially XGB. Such models may help neonatologists in the early diagnosis of high-risk infants for PGF for early intervention.