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Cao R, Ye W, Liu J, Chen L, Li Z, Ji H, Zhou N, Zhu Q, Sun W, Ni C, Shi L, Zhou Y, Wu Y, Song W, Liu P. Dynamic influence of maternal education on height among Chinese children aged 0-18 years. SSM Popul Health 2024; 26:101672. [PMID: 38708407 PMCID: PMC11066550 DOI: 10.1016/j.ssmph.2024.101672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/25/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024] Open
Abstract
Background Maternal education is one of key factors affecting nurturing environment which significantly impacts children's height levels throughout their developmental stages. However, the influence of maternal education on children's height is less studied. This study aims to investigate the dynamic influence of maternal education on children's height among Chinese children aged 0-18 years. Methods Children undergoing health examinations from January 2021 to September 2023 were included in this study. Clinical information including height, weight, maternal pregnancy history, blood specimens for bone metabolism-related indicators and maternal education level was collected. Children's height was categorized into 14 groups based on age and gender percentiles, following WHO 2006 growth standards. One-way analysis of variance (ANOVA), linear regression, chi-square test and Fisher's exact test were applied for data analysis. Results A total of 6269 samples were collected, including 3654 males and 2615 females, with an average age of 8.38 (3.97) for males and 7.89 (3.55) for females. Significant correlations between maternal education level, birth weight, birth order, weight percentile, vitamin D, serum phosphorus, alkaline phosphatase levels, and children's height were identified. Birth weight's influence on height varied across age groups. Compared with normal birth weight children, low birth weight children exhibited catch-up growth within the first 6 years and a subsequent gradual widening of the height gap from 6 to 18 years old. Remarkably, the impact of maternal education on height became more pronounced among children above 3-6 years old, which can mitigate the effect of low birth weight on height. Conclusion We found that weight percentile, birth weight, birth order, bone marker levels, and maternal education level have significant effect on height. Maternal education attenuates the impact of low birth weight on height. The findings indicated that maternal education plays a consistent and critical role in promoting robust and healthy growth.
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Affiliation(s)
- Ruixue Cao
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Wenjing Ye
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Jinrong Liu
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Lili Chen
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Zhe Li
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Hanshu Ji
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Nianjiao Zhou
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Qin Zhu
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Wenshuang Sun
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Chao Ni
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
| | - Linwei Shi
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Yonghai Zhou
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
| | - Yili Wu
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, Zhejiang Province, 325035, China
| | - Weihong Song
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and the Affiliated Kangning Hospital, North Building of Biological Research, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, Zhejiang, 325035, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), 999 Jinshi Road, Yongzhong Street, Longwan District, Wenzhou, Zhejiang Province, 325035, China
| | - Peining Liu
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Lucheng District, Wenzhou, Zhejiang Province, 325035, China
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Pai SR, Padmanabha R, Kamalakar S, Aravind JV, Puttaswamy D, Pn Rao S, Jois SK, Kamath A, Kuriyan R. Comparison of growth patterns in the first year of life between term small for gestational age and appropriate for gestational age South Indian infants. BMJ Paediatr Open 2024; 8:e002477. [PMID: 38719565 PMCID: PMC11086450 DOI: 10.1136/bmjpo-2023-002477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Early life growth trajectories of Indian small for gestational age (SGA) infants are sparse. This study aimed to compare longitudinal growth in appropriate for gestational age (AGA) and SGA infants during their first year of life. METHODS Apparently healthy term infants (52 SGA, 154 AGA) were recruited at birth and followed up till 1 year. Parental, sociodemographic characteristics and feeding patterns were recorded. Anthropometric measurements were assessed at birth, 3, 6, 9 and 12 months of age; Z scores and growth velocity at 3-month intervals were computed. Longitudinal measurements were compared between the two groups, using the two-way Friedmans test. Median regression with mixed effects was used to adjust covariates; p value <0.05 was considered statistically significant. RESULT AGA infants had significantly higher median weight (kg) (2.87 (2.67, 3.04) vs 2.39 (2.25, 2.54)) at birth, (7.08 (6.50, 7.54) vs 6.49 (6.13, 6.78)) at 6 months, (8.64 (7.92, 9.14) vs 7.90 (7.36, 8.54)) at 12 months, median length (cm) ((48.10 (47.20, 49.30) vs 46.75 (45.43, 47.50)) at birth, (65.50 (64.23, 66.98) vs 63.33 (62.26, 65.28)) at 6 months, (73.30 (71.58, 74.66) vs 71.55 (70.00, 73.30)) at 12 months. SGA infants had comparable weight velocity at all intervals except 9-12 months (6.62 (6.45, 6.79) vs (6.70 (6.51, 6.85)), being significantly higher than AGA infants. Differences in skinfold thicknesses between groups were observed only at birth. Exclusivity of breast feeding was significantly higher at 3 months in AGA, compared to SGA infants (80.9% vs 57.8%). Length velocity was comparable at all ages between groups. Sexual dimorphism was observed in the growth velocities of both groups. CONCLUSION SGA infants grew in parallel to AGA infants, having significantly lower anthropometric measurements at all time points. However, growth velocities were similar; SGA infants had significantly higher weight velocity from 9 to 12 months. Longitudinal studies beyond 1 year of age, using body composition are needed to determine the quality of growth in Indian infants.
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Affiliation(s)
- Shruti R Pai
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Ramya Padmanabha
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Sanjana Kamalakar
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Jini V Aravind
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Deepa Puttaswamy
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Suman Pn Rao
- Department of Neonatology, St John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Srinivas K Jois
- Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Asha Kamath
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
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Hosseini SA, Fouladinejad M, Mirfazeli A, Aghapour SA, Hosseini houshyar SH, hossiani PS, Alaei E, Mirzaei H. Evaluation of facial anthropometric characteristics in infants born in north of Iran. JOURNAL OF NEONATAL NURSING 2024; 30:38-43. [DOI: 10.1016/j.jnn.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2024]
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Joseph J, Jalal R, Sood M, Chellani H, Pandey RM, Goyal R, Ramji S, Dasgupta R. Turning the Gaze from Survive to Thrive for Children in India: Learnings from Two Case Studies. Indian J Pediatr 2023; 90:71-76. [PMID: 37540471 DOI: 10.1007/s12098-023-04712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/19/2023] [Indexed: 08/05/2023]
Abstract
Despite significant efforts and progress made in newborn care programs in India, implementation gaps persist across the continuum of care. The present case studies of two districts in Himachal Pradesh revealed that pathways of care were often fragmented with inconsistent linkages between facility and community due to poor documentation, lack of tiered referral, health system weaknesses, low utilization of primary level institutions, and inadequate post-natal home visits by Accredited Social Health Activists (ASHAs). Involvement of healthcare providers (HCPs) and frontline health workers (FHWs) was low and uneven in generating awareness across the districts with limited participation in supporting care in the community. Ensuring functionality of health centers and first-level care facilities; strengthening referral systems; adequate/trained human resources; strengthening routine health management systems, discharge processes and community-based care with adequate integration with facilities are necessary in closing access gaps.
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Affiliation(s)
- Jessy Joseph
- Global Access Research, International AIDS Vaccine Initiative (IAVI), New Delhi, India
| | - Ruchita Jalal
- Global Access Research, International AIDS Vaccine Initiative (IAVI), New Delhi, India
| | - Mangla Sood
- Department of Pediatrics, Indira Gandhi Medical College, Shimla, India
| | - Harish Chellani
- (Former) Department of Pediatrics, Vardhman Mahavir Medical College, New Delhi, India
| | - R M Pandey
- (Former) Department of Biostatistics, All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Rajat Goyal
- International AIDS Vaccine Initiative (IAVI), New Delhi, India
| | - Siddarth Ramji
- (Former) Department of Neonatology, Maulana Azad Medical College, New Delhi, India
| | - Rajib Dasgupta
- Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, Room No 204, New Delhi, India.
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Samuel SR, Lai CWM, Khan MM, Mathew MG, Kramer MS, Hsu CYS. Gestational Serum Retinol Deficiency Is Associated with Enamel Hypoplasia. J Dent Res 2023; 102:1417-1424. [PMID: 37899507 DOI: 10.1177/00220345231200788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Enamel hypoplasia (EH) is a prevalent developmental defect of teeth that can result from various insults, including prenatal nutrient deficiencies. This study aimed to evaluate the association between prenatal serum retinol deficiency and EH in the deciduous teeth of offspring at 2-y of age. A cohort of 1,450 pregnant women was enrolled, and their prenatal nutritional status was assessed between 12 and 14 wk of gestation. Maternal serum retinol, serum 25-hydroxyvitamin D (25OHD), hemoglobin, body mass index, and birth outcomes, infant feeding practices, family socioeconomic status, and demographic information were recorded. Oral health examinations were conducted for the children semiannually, and EH was diagnosed using the Modified DDE index on all the surfaces of erupted teeth. A modified Poisson regression analysis was used to assess the cumulative risk of EH over a period of 2-y. A total of 920 (63.4%) mother-child pairs completed the study, and the cumulative EH prevalence among offspring after 2-y of follow-up was 16.5% (N = 152; 87/1,114 children in the first year and 132/920 in the second year, with 20/920 having EH only in the first year). After adjusting for potential confounders, maternal serum retinol deficiency significantly increased the risk of deciduous EH (risk ratio [RR], 2.0; 95% confidence interval [CI], 1.1-3.7). In addition, deficient serum 25OHD (RR, 6.5; 95% CI, 4.0-10.7), caesarean delivery (RR, 1.6; 95% CI, 1.0-2.4), Muslim (RR, 2.9; 95% CI, 2.0-4.1) and Christian (RR, 2.4; 95% CI, 1.6-3.5) versus Hindu religions, and very preterm birth (RR, 1.7; 95% CI, 1.1-2.9) increased the risk of EH. Children presenting with EH had 2 or more teeth affected, and the maxillary incisors were the most frequently affected, followed by the first primary molars and canines. In conclusion, maternal serum retinol deficiency during the 12 to 14 wk of gestation may increase the risk of deciduous EH, besides the well-established 25OHD deficiency.
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Affiliation(s)
- S R Samuel
- The Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - C W M Lai
- Faculty of Dentistry, National University of Singapore, Singapore
| | - M M Khan
- Department of Pediatric Dentistry, Taif University, Taif, Saudi Arabia
| | - M G Mathew
- Pediatric and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - M S Kramer
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University Faculty of Medicine, Montreal, Canada
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - C-Y S Hsu
- Faculty of Dentistry, National University of Singapore, Singapore
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Kumar D, Sharma S, Raina SK. Risk of Childhood Obesity in Children With High Birth Weight in a Rural Cohort of Northern India. Indian Pediatr 2023. [DOI: 10.1007/s13312-023-2805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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7
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Jain V, Kumar B, Jana M. Bone Mineral Content and Density in Healthy Term Indian Infants at the Age of 1 and 2 Years Assessed by Dual-Energy X-Ray Absorptiometry. Indian J Pediatr 2023; 90:190-192. [PMID: 36539567 DOI: 10.1007/s12098-022-04412-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022]
Abstract
There is a paucity of data on the bone mineral status of infants, with no data from India. This study was undertaken to assess the bone mineral content (BMC) of the healthy term Indian infants at 1 and 2 y of age, and the influence of factors such as birth weight, gender, current size, and vitamin D levels on BMC. Anthropometry, serum 25-hydroxyvitamin-D levels, and dual-energy X-ray absorptiometry (DXA) for the lumbar spine and whole-body BMC were performed at the ages of 1 and 2 y.Mean whole-body BMC was 214.1 ± 40.8 g at 1 y (n = 131) and 327.6 ± 87.4 g at 2 y (n = 73); lumbar spine BMC was 6.9 ± 1.8 g at 1 y and 10.2 ± 3.8 g at 2 y. The chief determinants of BMC were the weight and length/height of the infant, with no effect of vitamin D levels. The BMC of Indian infants at 1 y was similar to that reported previously for Caucasian infants.
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Affiliation(s)
- Vandana Jain
- Division of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Brijesh Kumar
- Division of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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Joseph J, Jalal R, Nagrath M, Dasgupta R, Chellani H, Pandey RM, Sood M, Goyal R, Ramji S. Growth Faltering Among Discharged Babies from Inpatient Newborn Care Facilities: Learnings from Two Districts of Himachal Pradesh. Indian Pediatr 2022. [DOI: 10.1007/s13312-022-2618-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jain V, Kumar B, Devi S, Jain A, Jana M, Kurpad AV. Body composition from birth to 2 years in term healthy Indian infants measured by deuterium dilution: Effect of being born small for gestational age and early catch-up growth. Eur J Clin Nutr 2022; 76:1165-1171. [PMID: 35173289 DOI: 10.1038/s41430-022-01071-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES South Asian body composition is characterized by higher body fat at any given BMI. While this does not occur during fetal growth, it is important to understand if inappropriate fat accretion then begins in the first 2 years in Indian infants. METHODS The fat mass (FM) and fat-free mass (FFM) of healthy term newborns was evaluated at 12 days, 3.5 months, 1 year, and 2 years, by deuterium oxide (D2O) dilution. The effect of being born small versus appropriate for gestational age (SGA vs. AGA), and accelerated early growth pattern on FM and FFM accretion was also investigated. RESULTS Newborns (262 total, 150 males) with mean birth weight of 2863 ± 418 g were enrolled. FM percentage (FM%) assessed by D2O in 144, 166, 81, and 115 infants at 12 days, 3.5 months, 1 year, and 2 years respectively, was11.6 ± 6.8, 21.1 ± 7.0, 17.9 ± 8.2 and 22.4 ± 9.5%. Boys had higher FFM at all ages, but FM% was similar in both sexes. Children born SGA had similar FM index (FMI) but a lower FFM index (FFMI) at 2 years compared with those born AGA. Infants with catch-up growth between 0 and 2 years had higher FMI at 2 years compared to those without. Infants in the present study had a lower FM% and FMI till 1 year of age in comparison to previous studies from other countries, but had an increase in adiposity between 1 and 2 years, whereas in previous studies FM% remained stable or declined between 1 and 2 years of age. CONCLUSION There was an upward inflection in the curve of FM% and FMI between 1 and 2 years of age in the present study, which may represent an early adiposity rebound. Further longitudinal body composition data for Indian infants as well as those of other ethnicities but with low birth weight will clarify whether early accelerated growth pattern contributes to greater accrual of fat rather than lean mass during childhood.
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Affiliation(s)
- Vandana Jain
- Division of Paediatric Endocrinology, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Brijesh Kumar
- Division of Paediatric Endocrinology, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sarita Devi
- Department of Physiology and Nutrition, St. John's Medical College, Bengaluru, India
| | - Avnika Jain
- MBBS student, Maulana Azad Medical College, New Delhi, India
| | - Manisha Jana
- Department of Radiodiagnosis and Intervention Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anura V Kurpad
- Department of Physiology and Nutrition, St. John's Medical College, Bengaluru, India.
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Lan S, Fu H, Zhang R, Zhong G, Pan L, Bei F, Hong L. Extrauterine growth restriction in preterm infants: Postnatal growth pattern and physical development outcomes at age 3-6 years. Front Pediatr 2022; 10:945422. [PMID: 35967552 PMCID: PMC9372328 DOI: 10.3389/fped.2022.945422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To investigate the postnatal growth trajectories of preterm infants and evaluate the association between extrauterine growth restriction (EUGR) at discharge and adverse physical growth outcomes at age 3-6 years. METHODS Premature infants admitted to Shanghai Children's Medical Center within 24 h after birth from 1 January 2016 to 31 December 2018 were enrolled. Neonatal complications, nutrition support, and anthropometric data were collected and analyzed to diagnose EUGR on different definitions at discharge. The weight and the height of each subject were collected by telephone investigation from 1 September 2021 to 31 November 2021 to access the incidences of overweight/obesity, short stature, and thinness at age 3-6 years. RESULTS A total of 527 preterm infants were included in the final sample. The overall mean weight and height Z-scores were -0.37 ± 0.97 SD and -0.29 ± 1.18 SD at birth, and increased to -0.03 ± 1.11 SD and 0.13 ± 1.2 SD at follow-up, respectively. The logistic regression analysis indicated longitudinal EUGR on head circumference as the risk factor of overweight or obesity, cross-sectional EUGR on height as the risk factor of short stature, and delayed EN as the risk factor of thinness. CONCLUSION The growth trajectories of the preterm newborns tended toward the normal direction. Longitudinal EUGR on the head circumference and cross-sectional EUGR on height at discharge were associated with adverse physical growth outcomes at age 3-6 years.
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Affiliation(s)
- Siyuan Lan
- Department of Clinical Nutrition, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Huanhuan Fu
- Department of Clinical Nutrition, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Zhang
- Department of Pediatrics, Fujian Provincial Maternity and Children's Hospital, Fujian Medical University, Fujian, China
| | - Guimei Zhong
- Department of Neonatal Intensive Care Unit, Quanzhou First Hospital, Fujian, China
| | - Liya Pan
- Department of Clinical Nutrition, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fei Bei
- Department of Neonatology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Hong
- Department of Clinical Nutrition, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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