Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Dec;89(12):967-72.
doi: 10.1016/j.earlhumdev.2013.09.008. Epub 2013 Sep 29.

Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population

Samuel Clark Berngard  1 , Jennifer Bishop Berngard, Nancy F Krebs, Ana Garcés, Leland V Miller, Jamie Westcott, Linda L Wright, Mark Kindem, K Michael Hambidge
Affiliations

Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population

Samuel Clark Berngard et al. Early Hum Dev. 2013 Dec.

Abstract

Background: Stunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala.

Aim: The 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 subjects: One 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.

Results: Mean ± 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 (R(2) = 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.

Conclusion: The 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.

Keywords: AIC; Akaike Information Criterion; Birth weight; IFS; IUGR; Infant growth; LAZ; LMP; Linear growth; Predictors of infant growth; SES; VIF; WAZ; WLZ; intra-uterine growth retardation; iron folate supplement; last menstrual period; length-for-age Z-score; socio-economic status; variance inflation factor; weight-for-age Z-score; weight-for-length Z-score.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None of the authors have any conflict of interest to report.

Figures

Figure 1
Figure 1
Mean (+SD) length-for-age (LAZ), weight-for-age (WAZ) and weight-for-length (WLZ) in newborn and infants at 3 and 6 mo of age.
Figure 2
Figure 2
A 3-dimensional plot of the relationship of the maternal education * maternal age interaction and LAZ at 3 mo predicted by the model. The plot shows that increased education was associated with higher LAZ at 3 mo and that this relationship was enhanced when the mothers were older. The model surface is calculated for females with average newborn LAZ and WAZ values. The upper corner of the surface (at high values of both education and age) extends beyond the range of the data as none of the older mothers had the highest levels of education.
Figure 3
Figure 3
WAZ vs. LAZ at 3 mo showing the linear regression line (solid line) with slope of 0.64. Dotted lines depict zero Z-scores for WAZ and LAZ and the dashed line is the identity line. The divergence of the regression and identity lines as LAZ and WAZ decrease demonstrates that WAZ trends higher relative to LAZ (P < 0.0001).
See this image and copyright information in PMC

References

    1. Caulfield LE, de Onis M, Blossner M, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr. 2004;80(1):193–8. - PubMed
    1. Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226–34. - PubMed
    1. Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371(9610):417–40. - PubMed
    1. Victora CG, de Onis M, Hallal PC, Blossner M, Shrimpton R. Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics. 2010;125(3):e473–80. - PubMed
    1. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60. - PubMed

Publication types