Length‐for‐age (HAZ) progression from the 1st to the 4‐6th month among rural and urban infants in the Western Highlands of Guatemala: longitudinal and cross‐sectional perspectives (620.11)

Abstract

Background: We have recently signaled the poorly recognized high prevalence of stunting at birth ‐ a challenge for prevention of linear growth retardation.Objectives: To assess and compare the progression of mean HAZ and stunting rates between the 1st and the 4th‐6th mo in rural R and urban U infants in the Western Highlands of Guatemala.Methods: Two field studies in the Province of Quetzaltenango ‐ Mam‐Mamas (a saturation survey in 8 R Mam‐Mayan‐speaking communities) and Xela‐Babies (a convenience sample from an U health clinic) ‐ included anthropometry measurement in the first 45 and at 131‐182 days of life, in a longitudinal format in both locations and in a transverse manner at the R site only. Stunting was defined as <‐2 SD of HAZ (2006 WHO growth standards).Results: In the cohort series, the HAZ declined at the R site from an initial median of ‐1.61 (stunting prevalence 34.9%) to ‐1.79 (39.8%) (n=129; ΔHAZ ‐0.009±0.070 units/wk); and rose at the U site from ‐1.45 (25.0%) to ‐1.38 (28.3%) (n=60; ΔHAZ +0.011±0.046 u/wk). The stunting prevalence was significantly higher at 4‐6 mo at the R vs U site (p=0.012); HAZ progression was not statistically significant at either site. In the cross‐sectional samples from the R site, the progression was ‐1.89 (40.8%) (n=71) to ‐2.06 (50%) (n=60; ΔHAZ ‐0.010 u/wk).Conclusions: This, to our knowledge, is the first report on the progression of linear growth failure within the first 6 mo of life. Within our study setting, stunting begins in utero, and is worse at the R site, with no statistically significant progression in HAZ scores between the first 6 mo of life.Grant Funding Source: Supported by Graduate Women in Science, McGill Univ Grad Travel Award, GHR‐CAPS Doctoral Fellowship