Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population |
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Authors: | Samuel Clark Berngard Jennifer Bishop Berngard Nancy F Krebs Ana Garcés Leland V Miller Jamie Westcott Linda L Wright Mark Kindem K Michael Hambidge |
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Institution: | 1. University of Colorado Denver, 12700 East 19th Avenue, Box C225, Aurora, CO 80045, United States;2. IMSALUD, 3ra calle, a6.56, zona 10, Guatemala City, Guatemala;3. National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, Rockville, MD 20852, United States;4. RTI, International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, United States |
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Abstract: | BackgroundStunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala.AimThe objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy.Study design and subjectsOne hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 months. Maternal measurements were also obtained.ResultsMean ± SD length-for-age Z-score (LAZ) declined from newborn − 1.0 ± 1.01 to − 2.20 ± 1.05 and − 2.26 ± 1.01 at 3 and 6 months respectively. Stunting rates for newborn, 3 and 6 months were 47%, 53% and 56% respectively. A multiple regression model (R2 = 0.64) demonstrated that the major predictor of LAZ at 3 months was newborn LAZ with the other predictors being newborn weight-for-age Z-score (WAZ), gender and maternal education ∗ maternal age interaction. Because WAZ remained essentially constant and LAZ declined during the same period, weight-for-length Z-score (WLZ) increased from − 0.44 to + 1.28 from birth to 3 months. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ.ConclusionThe primary conclusion is that impaired fetal linear growth is the major predictor of early infant linear growth failure indicating that prevention needs to start with maternal interventions. |
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Keywords: | AIC Akaike Information Criterion IUGR intra-uterine growth retardation IFS iron folate supplement LMP last menstrual period LAZ length-for-age Z-score SES socio-economic status VIF variance inflation factor WAZ weight-for-age Z-score WLZ weight-for-length Z-score |
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