Maternal and Infant Factors Associated with Child Growth in the First Year of Life

Mahama Saaka

doi:10.11648/j.sjph.20150305.36

Abstract

Aim: To assess the predictors associated with infant length-for-age Z-score (LAZ) in the first year of life. This paper presents the relative contribution of maternal and child factors to child growth among children aged 6-12 months in an urban area of Northern Region of Ghana. Methods: This was a retrospective cohort study design in which systematic random sampling technique was used to select study participants, who sought post natal care services in selected hospitals within Tamale Metropolis. The association between LAZ and explanatory variables (maternal height, birth weight, infant and child feeding practices) was assessed using both bivariate and multiple linear regression analyses. Results: The mean age of the children was 8.6±1.9 months and 53.8 % were in the 6-8 months age group. The mean dietary diversity score (DDS) was 4.18±1.69 for children aged 6-12 months. Nearly 70.0 % of the children had adequate meal frequency, 73.0 % met the minimum dietary diversity (≥ 4 food groups) and 57.5 % of the children met the minimum acceptable diet. The greatest predictors of mean LAZ were maternal height, low birth weight (LBW), whether child is wasted or not and the consumption of specific foods groups by the child. A 1-unit increase in weight for length z-score (WLZ) was associated with 0.156 decrease in length for age z-score (LAZ) [beta = -0.156 (95% CI: -0.26, -0.03)] among infants 6 to 8 months of age after controlling for LBW and maternal height. Among children 9-12 months, a unit increase in weight for length z-score (WLZ) was associated with 0.182 decrease in length for age z-score (LAZ) [beta = -0.182 (95% CI: -0.32, -0.04)]. The nature and strength of association between LBW and mean LAZ was different according to the age group of the child. Among children aged 6-8 months, the mean LAZ of LBW children were significantly higher than that of children whose birth weight was normal. For children aged 9-12 months, LBW children had lower mean LAZ compared to children with birth weight of at least 2.5 kg (beta coefficient = -0.320, p < 0.001). Conclusion: In conclusion, the effect of birth weight and maternal height on LAZ depended on the age of the child. The data do suggest that between the ages of 6-8 months, LBW babies may be growing faster in length than non-LBW babies. However, from 9-12 months non-LBW babies grow faster than LBW babies.

Highlights

Childhood under nutrition is a recognized public health problem that is associated with high levels of childhood illness and death in many developing countries including Ghana
The nature and strength of association between birth weight and mean length for age z-score (LAZ) were different according to the age group of the child
The main finding was that effect of birth weight and maternal height on LAZ depended on the age of the child

Summary

Introduction

Acute under nutrition (wasting) occurs as a consequence of short-term response to inadequate intake or an infectious disease episode, whereas chronic under nutrition (stunting) emanates from a longer term response to a sustained poor dietary intake or repeated illnesses. The causes of these two forms of under nutrition are not exactly the same and the association between them in children is less understood (Gorstein et al, 1994, Keller, 1983, Martorell, 1985, Victora, 1992). The birth weight of a child is the result of intrauterine growth as well as the length of gestation

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