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

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 [AZ 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. (C) 2013 Elsevier Ireland Ltd. All rights reserved