Abstract
BackgroundAlthough linear growth during childhood may be affected by early-life exposures, few studies have examined whether the effects of these exposures linger on during school age, particularly in low- and middle-income countries.MethodsWe conducted a population-based longitudinal study of 256 children living in the Brazilian Amazon, aged 0.1 y to 5.5 y in 2003. Data regarding socioeconomic and maternal characteristics, infant feeding practices, morbidities, and birth weight and length were collected at baseline of the study (2003). Child body length/height was measured at baseline and at follow-up visits (in 2007 and 2009). Restricted cubic splines were used to construct average height-for-age Z score (HAZ) growth curves, yielding estimated HAZ differences among exposure categories at ages 0.5 y, 1 y, 2 y, 5 y, 7 y, and 10 y.ResultsAt baseline, median age was 2.6 y (interquartile range, 1.4 y–3.8 y), and mean HAZ was −0.53 (standard deviation, 1.15); 10.2% of children were stunted. In multivariable analysis, children in households above the household wealth index median were 0.30 Z taller at age 5 y (P = 0.017), and children whose families owned land were 0.34 Z taller by age 10 y (P = 0.023), when compared with poorer children. Mothers in the highest tertile for height had children whose HAZ were significantly higher compared with those of children from mothers in the lowest height tertile at all ages. Birth weight and length were positively related to linear growth throughout childhood; by age 10 y, children weighing >3500 g at birth were 0.31 Z taller than those weighing 2501 g to 3500 g (P = 0.022) at birth, and children measuring ≥51 cm at birth were 0.51 Z taller than those measuring ≤48 cm (P = 0.005).ConclusionsResults suggest socioeconomic background is a potentially modifiable predictor of linear growth during the school-aged years. Maternal height and child’s anthropometric characteristics at birth are positively associated with HAZ up until child age 10 y.
Highlights
Linear growth during childhood may be affected by early-life exposures, few studies have examined whether the effects of these exposures linger on during school age, in low- and middleincome countries
In 2003, height-for-age Z score (HAZ) was positively associated with wealth index, maternal education and height, non-smoking during pregnancy, and child’s birth weight and length
Co-variates in the model: model 5 plus morbidities in the past 15 days. In this population-based cohort study of children from the Brazilian Amazon, socioeconomic background was positively related to linear growth during the school-aged years, whereas maternal height and child birth weight and length were associated with height up until age 10 y
Summary
Linear growth during childhood may be affected by early-life exposures, few studies have examined whether the effects of these exposures linger on during school age, in low- and middleincome countries. Little is known about the influences of early-life exposures on linear growth during school age, especially in low- and middle-income countries. Understanding these influences would provide critical information as to whether the adverse impact of early exposures on growth lingers on throughout childhood or may be reversed. The aim of this study was to investigate socioeconomic, maternal, and child determinants of linear growth up to age 10 y in a population-based cohort study of children living in the Brazilian Amazon
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