Metrics of early childhood growth in recent epidemiological research: A scoping review.

Michael Leung,Seungmi Yang,Daniel E Roth,Elnathan Mesfin,Diego G Bassani,Aditi Krishna,William Johnson,Nandita Perumal,Iratxe Puebla

doi:10.1371/journal.pone.0194565

Abstract

Metrics to quantify child growth vary across studies of the developmental origins of health and disease. We conducted a scoping review of child growth studies in which length/height, weight or body mass index (BMI) was measured at ≥ 2 time points. From a 10% random sample of eligible studies published between Jan 2010-Jun 2016, and all eligible studies from Oct 2015-June 2016, we classified growth metrics based on author-assigned labels (e.g., ‘weight gain’) and a ‘content signature’, a numeric code that summarized the metric’s conceptual and statistical properties. Heterogeneity was assessed by the number of unique content signatures, and label-to-content concordance. In 122 studies, we found 40 unique metrics of childhood growth. The most common approach to quantifying growth in length, weight or BMI was the calculation of each child’s change in z-score. Label-to-content discordance was common due to distinct content signatures carrying the same label, and because of instances in which the same content signature was assigned multiple different labels. In conclusion, the numerous distinct growth metrics and the lack of specificity in the application of metric labels challenge the integration of data and inferences from studies investigating the determinants or consequences of variations in childhood growth.

Highlights

There is substantial ongoing investment in research into the early life factors that influence the development of chronic diseases such as obesity and cardiovascular disease
We conducted a scoping review to systematically summarize the variability in metrics of early childhood growth in recently published human growth research, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines (S1 File) [29]
We sought to include peer-reviewed longitudinal studies published from January 2010 to June 2016 in which child growth was used as an exposure variable or outcome variable and the analytical approach used ! 2 serial measures of length/height, weight or body mass index (BMI), with at least one measure taken in the period between birth to 5 years

Summary

Introduction

There is substantial ongoing investment in research into the early life factors that influence the development of chronic diseases such as obesity and cardiovascular disease. Of particular interest is the hypothesis that a child’s size at birth and the subsequent infant and early childhood growth (i.e., change in size over time) influence the risk of later metabolic and cardiovascular conditions [1]. Epidemiologic studies of the developmental origins of health and disease (DOHaD) hypothesis often rely on quantitative measures of early childhood growth that distinguish children with respect to their relative rates of growth The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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