The Impact of Prenatal Alcohol Exposure on Longitudinal Growth, Nutritional Status, and Insulin-Like Growth Factor 1 in Early Childhood in Leyte, the Philippines

OBJECTIVE

To assess the impact and potential mechanistic pathways of prenatal alcohol exposure (PAE) on longitudinal growth and nutritional status in early childhood.

STUDY DESIGN

A cohort of 296 mother-infant dyads (32% with PAE vs 68% unexposed) were recruited in Leyte, the Philippines, and followed from early gestation through 24 months of age. PAE was assessed using serum phosphatidylethanol (PEth) captured twice prenatally and in cord blood and supplemented with self-reported alcohol consumption. Linear mixed models were used to examine longitudinal effects of PAE on growth from birth through 2 years including key potential mediating factors (placental histopathology, and infant serum leptin and Insulin-like Growth Factor 1 [IGF-1]).

RESULTS

After adjusting for potential confounders, we found that PAE was significantly associated with a delayed blunting of linear growth trajectories (height-for-age z-score, body length) and weight (weight-for-age z-score, body weight) that manifested between 4 and 6 months and continued through 12-24 months. PAE was also associated with a decreased rate of mid-upper-arm circumference growth from birth to 12 months, and a lower mean IGF-1 levels at birth and 6 months.

CONCLUSION

This study demonstrates a delayed impact of PAE on growth that manifested around 6 months of age, underscoring the importance of routine clinical monitoring in early childhood. Furthermore, the findings supported prior animal model findings that suggest a mechanistic role for IGF-1 in PAE-induced growth delay.

Impaired Intrauterine Growth in the Context of Maternal Hookworm Infection During Gestation

Hookworm infection is associated with poor nutritional outcomes, anemia, and impaired cognitive performance. We examined the association between maternal hookworm infection and birth outcomes in a cohort of women in Leyte, Philippines. We observed poor intrauterine growth characteristics associated with maternal hookworm only among male offspring, with lower birth weight, head circumference, and placental surface area. Male neonates also had higher insulin-like growth factor 2 (IGF-2) and lower adiponectin in cord blood. These data intriguingly suggest nutritional impacts of maternal hookworm infection during pregnancy may be divergent based on sex of the offspring.

Parental perceptions of the preschool obese child

Childhood obesity is a serious public health problem today with many potential complications and adverse outcomes for children. How parents view their children's weight is an important consideration for nurses. The purpose of this study was to increase staff understanding of parents' views so that interventions could be developed to achieve improved outcomes in attenuating the rate of weight gain in obese children. A questionnaire was administered to 200 parents, mostly Hispanic, of obese children to determine the parents' perceptions of their child's obesity. The study revealed that 35% of parents did not believe their obese child was overweight and 53% had no problem controlling what their child eats. However, 78% of parents expressed concern about heart disease as a consequence of childhood obesity. The study demonstrated that parents acknowledge some health risks of obesity but that interventions in treating childhood obesity need to begin with the understanding of parents' perceptions of their own child's obesity.