LBW and SGA Impact Longitudinal Growth and Nutritional Status of Filipino Infants

• Published in: PloS one Vol. 11; no. 7; p. e0159461
• Main Authors: Blake, Rachel A, Park, Sangshin, Baltazar, Palmera, Ayaso, Edna B, Monterde, Donna Bella S, Acosta, Luz P, Olveda, Remigio M, Tallo, Veronica, Friedman, Jennifer F
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21-07-2016; Public Library of Science (PLoS)
• Subjects: Age; Analysis; Biology and Life Sciences; Birth Weight; Births; Breast feeding; Breastfeeding & lactation; Causes of; Children & youth; Female; Fetuses; Food and nutrition; Gestational Age; Growth and Development; Health aspects; Hospitals; Humans; Infant; Infant mortality; Infant, Newborn; Infant, Small for Gestational Age - physiology; Infants; Influence; Longitudinal Studies; Low income groups; Male; Malnutrition; Mathematical models; Medical research; Medical schools; Medicine; Medicine and Health Sciences; Models, Biological; Multivariate Analysis; Neonates; Newborn babies; Newborn infants; Nutritional requirements; Nutritional status; Nutritional Status - physiology; Pediatrics; People and Places; Philippines; Physiological aspects; Risk reduction; Small for gestational age; Social Sciences; Studies; Thinness; Tropical diseases; Undernutrition; Underweight; Womens health; Philippines
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0159461

We performed this study to longitudinally compare rates of stunting, wasting and underweight among low birthweight (LBW), non-LBW, and/or small-for-gestational age (SGA) and non-SGA infants in Leyte, The Philippines and factors that predicted catch up. Birthweights of 357 infants born in Leyte, The Philippines were obtained within 48 hours of delivery and infants were evaluated at one, six and 12 months. Newborns were classified as LBW, SGA, or both. We derived length-for-age, weight-for-length and weight-for-age Z-scores using WHOAnthro. Generalized estimating equations models were used to compare the differences in prevalence and mean Z-scores for these growth and nutritional outcomes, with separate models made with LBW and SGA as distinct primary predictors. We compared the longitudinal risk of stunting, wasting and underweight during infancy among LBW versus non-LBW and SGA versus non-SGA infants, while also evaluating key potential confounding, explanatory and modifying covariates. Overall, 9.0% of infants were born prematurely, 14.0% of infants were LBW and 22.9% were SGA. LBW infants had significantly increased odds of stunting, wasting and underweight persisting to 12 months of age, and SGA infants had significantly increased odds of stunting and underweight. LBW and SGA infants had higher rates of weight-for-length gain in the first month of life. Maternal educational attainment and exclusive breastfeeding decreased the risk of stunting and undernutrition. In this setting, LBW and SGA infants have higher rates of growth stunting and undernutrition during the first year of life and do not exhibit catch-up growth by 12 months of age. Clinical Trial Registration NCT00486863