Identifying Prenatal and Postnatal Determinants of Infant Growth: A Structural Equation Modelling Based Cohort Analysis.

Kelly Morgan,Rebecca Hill,Shang-Ming Zhou,Shantini Paranjothy,Ronan A Lyons,Sinead T Brophy

doi:10.3390/ijerph181910265

Abstract

Background: The growth and maturation of infants reflect their overall health and nutritional status. The purpose of this study is to examine the associations of prenatal and early postnatal factors with infant growth (IG). Methods: A data-driven model was constructed by structural equation modelling to examine the relationships between pre- and early postnatal environmental factors and IG at age 12 months. The IG was a latent variable created from infant weight and waist circumference. Data were obtained on 274 mother–child pairs during pregnancy and the postnatal periods. Results: Maternal pre-pregnancy BMI emerged as an important predictor of IG with both direct and indirect (mediated through infant birth weight) effects. Infants who gained more weight from birth to 6 months and consumed starchy foods daily at age 12 months, were more likely to be larger by age 12 months. Infant physical activity (PA) levels also emerged as a determinant. The constructed model provided a reasonable fit (χ2 (11) = 21.5, p < 0.05; RMSEA = 0.07; CFI = 0.94; SRMR = 0.05) to the data with significant pathways for all examined variables. Conclusion: Promoting healthy weight amongst women of child bearing age is important in preventing childhood obesity, and increasing daily infant PA is as important as a healthy infant diet.

Highlights

The growth and maturation of infants reflect their overall health and nutritional status
Understanding the factors that contribute to infant growth in terms of weights and sizes allows the early detection of childhood health problems, such as childhood obesity, pathological deviations
Our model revealed that some maternal factors, such as age, ethnicity, education and income did not work significantly to predict early infant size, while the maternal pre-pregnancy BMI was an important factor affecting the infant size in both direct and indirect causal effects; the latter was mediated through infant birth weight

Summary

Introduction

The growth and maturation of infants reflect their overall health and nutritional status. The first 1000 days of life, including gestation and the first two years of age, is a critical period of infant growth that may shape the adulthood health and well-being of individuals [1,2]. Understanding the factors that contribute to infant growth in terms of weights and sizes allows the early detection of childhood health problems, such as childhood obesity, pathological deviations (e.g., short stature due to malnutrition and infection [3,4], poor weight gain due to genetic, endocrine and metabolic disorders [5,6,7,8]).

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