Height Z-score Research Articles

The influence of feeding practices on under-five nutrition status in Mbinga District, Tanzania

Background: Undernutrition is a universal public health problem for both children and adults globally. It is not only a public health concern but also an impediment to global poverty reduction, productivity, and economic growth. Under-five children are among the most vulnerable groups, although it affects both women, the elderly, and youth. This study assessed the influence of feeding practices on under-five nutrition status in Mbinga District, Tanzania. This paper unveils the contribution of feeding practices to underfive nutrition status in Tanzania. Methods: A cross-sectional study involved 150 heads of households whose children aged 0–59 months were assessed to determine their anthropometric measurements. Weigh for age Z-scores, height for age Z-scores, and weight for height Z-scores. A structured questionnaire was administered to collect data from the heads of households. Data were coded and analyzed by ENA for the SMART, Statistical Package for Social Sciences (SPSS), and STATA programs. Results: It is revealed that 90.7% of under-five children in the surveyed households initiated breastfeeding within one hour of life, 72% of the children were given complementary foods before six months, maize porridge was a major complementary food, and 80% of the children consumed three to four meals per day. Their diets were not diverse as starchy staple foods were dominant. It was further found that 42% of the children were stunted, 33% were wasted, and 25% were underweight. Moreover, the results of the ordered probit regression model showed that exclusive breastfeeding, meal frequency, and food dietary diversity were positively influencing nutrition status, while household size was negatively influencing the nutrition status of the under-five. Conclusion: The study concludes that inappropriate complementary feeding, children did not receive the minimum dietary diversity, and poor child feeding practices have a positive influence on the anthropometric status of the under-five. It was recommended that education be provided to community members on appropriate child feeding practices and family planning.

Association of Neonatal Antibiotic Exposure with Long-Term Growth Trajectory Faltering in Preterm-Birth Children

Plain Language SummaryPreterm infants often receive a variety of antibiotic exposure duration during admission. This study was to evaluate whether neonatal antibiotic exposure is associated with longitudinal growth problems in preterm-birth children. This study followed a cohort of 328 very preterm infants born <32 weeks of gestation, who were discharged from a tertiary hospital without documented neonatal bacterial infection from 2004 to 2016 and received longitudinal follow-up for growth outcomes at their corrected age (CA) 6, 12, 24, and 60 months. We collected perinatal demographics, neonatal morbidities, extrauterine growth restriction, and antibiotic exposure duration by term equivalent age, to associate with trajectories in z-scores of bodyweight (zBW), body height (zBH), and body mass index (zBMI) from CA 6–60 months. We found antibiotic exposure duration was negatively associated with zBW and zBH at CA 6, 12, and 60 months, and zBMI at CA 60 months. After adjustments, antibiotic exposure duration was associated with decreased growth velocity in zBW and zBH from CA 6–60 months. Children with longer antibiotic exposure >15 days had significantly lower zBW, zBH, and zBMI at CA 6, 12, 24, and 60 months compared with children with antibiotic exposure ≤15 days (all p < 0.01), suggesting that longer antibiotic exposure duration was associated with inferior weight and height gains. This study concludes that long-term growth increments may negatively associate with neonatal antibiotic exposure duration in children born very premature, implicating that antibiotic stewardship and growth follow-up for preterm neonates are thus warranted.

Utility of insulin-like growth factor-1 (IGF-1) in growth hormone-treated short children – An experience from a tertiary level center

Introduction: Very few studies have been conducted in low-middle-income countries to assess the response to growth hormone (GH) therapy by measuring the improvement in insulin-like growth factor-1 (IGF-1) concentrations. Objectives: The objective is to assess IGF-1 concentrations in patients receiving GH therapy to correlate the height increment with respect to increase in the IGF-1 concentrations, including IGF-1 Z-scores as a measure of safety profile. Methods: Clinical and anthropometric data were extracted retrospectively from hospital records of children aged 0–18 who received GH and had IGF-1 measured during the study period. Serum IGF-1 concentrations were analyzed by a solid-phase enzyme-linked immunosorbent assay. Patients with GH deficiency (GHD) and multiple pituitary hormone deficiency (MPHD) were grouped as group A, while participants receiving GH therapy for non-GHD/MPHD were clubbed as group B. Results: We report a significant positive correlation between an increase in IGF-1 values and increase in height. The improvement in height Z-scores was significantly higher in participants of group A as compared to B, with no significant difference in increase in IGF-1 Z-scores between the two groups. A total of 18.75% of subjects had IGF-1 Z-scores between +2 and +3, and these were largely subjects belonging to group B. Conclusion: The increment in height and height velocity Z-scores in the patients on GH correlated with increase in the IGF-1 concentrations, particularly in GHD/MPHD group of patients.

IMPROVEMENT IN GROWTH AND NUTRITION STATUS AFTER ANTI-TNF THERAPY INITIATION AMONG PATIENTS WITH PEDIATRIC CROHN’S DISEASE: RESULTS FROM THE COMBINE TRIAL

Abstract BACKGROUND Growth failure impacts 15-40% of children with Crohn’s disease (CD). Potential causes of growth failure include chronic inflammation, malabsorption, and poor nutritional intake. Control of inflammation is key to improving growth outcomes. Anti-TNF therapy has been associated with improved growth and nutritional status in affected children. Large studies of serial outcomes of growth after anti-TNF therapy initiation are limited. OBJECTIVE We sought to 1) describe baseline weight, height, and BMI status at anti-TNF initiation in children with CD in a large, multicenter clinical trial, 2) compare the demographic and clinical characteristics of children with and without weight, height, and BMI disturbance, and 3) describe follow-up anthropometric parameters at approximately 12 and 24 months after anti-TNF initiation. METHODS We analyzed data from the COMBINE trial, a multicenter study comparing infliximab or adalimumab in combination with oral methotrexate to anti-TNF monotherapy for children with CD. We obtained demographic, clinical, and anthropometric data at time of enrollment and after 12 and 24 months. Weight, height, and BMI Z-scores were dichotomized as normal (≥ -1) versus disturbance (&amp;lt; -1) at each time point. We used standard descriptive statistics to summarize the distribution of Z-scores and bivariate statistics to compare demographic, clinical, and treatment characteristics among participants with versus without growth disturbance at baseline. RESULTS Our study population included 199 children (25% female, 83% white, mean age 12 years). Of these, 53 (26.6%) had a weight disturbance at baseline (Table 1). Of 188 children with height data available at baseline, 52 (27.7%) had a height disturbance and 37 (19.7%) had a BMI disturbance. The mean short pediatric CD activity index (sPCDAI) was higher in those defined with weight, height, and BMI disturbance at baseline compared to those with normal parameters (Table 2). Gender, race, ethnicity, and age at time of anti-TNF initiation were not different between groups with and without weight, height, or BMI disturbances. Approximately 12 months after enrollment, the proportion of patients with height disturbance was 6.1% with a continued decrease to 0.9% at 24 months. BMI disturbance was observed in 7.5% of participants at 12 months and 2.8% at 24 months. Weight disturbance was observed among 5.7% and 0.8% of participants at 12 and 24 months respectively. DISCUSSION A substantial proportion of children with CD had weight, height, and BMI disturbance at time of anti-TNF initiation. These proportions decreased at approximately 12 months and 24 months, demonstrating significant improvement in growth disturbances after anti-TNF therapy. Table 1 % of children with weight, height, and BMI disturbance (Z-score &amp;lt;-1) at time of enrollment in addition to 12 and 24 months after anti-TNF therapy initiation. Table 2 Mean short pediatric Crohn’s disease activity index (sPCDAI) for BMI, weight, and height at time of anti-TNF initiation.

P1060 Diverting Ostomy for Crohn’s Pancolitis in Pediatric Patients

Abstract Background Childhood-onset Crohn’s disease (CD) is characterized by extensive anatomic involvement, with high rates of panenteric CD. Given the fact that total colectomy for these patients result in permanent loss of colonic absorption of nutrients, ostomy can be a good surgical option for children with Crohn’s pancolitis requiring surgical intervention. The purpose of this study was to retrospectively review the outcome of diverting ostomy for Crohn’s pancolitis in children. Methods Children with Crohn’s disease involving total colon with or without small intestine who underwent surgery were included. Preoperative patient features including extent of disease using Paris classification, nutritional status and medications were recorded. Outcomes analyzed included postoperative medication changes, nutrition and growth changes, postoperative complications and need for further operative interventions. Results We identified 13 patients with a median age of 11 years (range 5 months-15 years), all of whom had pancolitis at the time of surgery. All 13 patients underwent stoma formation, initially. Three patients received colectomy after median 24 months. Takedown rate was 38% (n=5) and the time from stoma formation to takedown was median 13 months (range 10-34 months). Weight and height z-score have been improved after ostomy. Conclusion Children with CD pancolitis could benefit from diverting ostomy which offers an opportunity to spare the large intestine partially or completely which could improve nutrition and growth. Outcome comparison between diverting ostomy and colectomy should be discussed with larger study populations.

Prevalence of stunting and determinants of growth failure in children with Type 1 diabetes

Objectives: India is home to the highest number of prevalent cases of Type-1 diabetes (T1D) in children. There is scarcity of data on the growth failure of children with diabetes, especially those having complications and comorbidities, thus, we conducted this study with the objective to determine the prevalence and predictors of stunting in children with T1D. Methods: This cross-sectional study included 350 children and adolescents aged 1–18 years with T1D. Demographic data, anthropometry, diet, sexual maturity rating, and biochemical measurements were performed using standard protocols. Short stature was defined as height for age Z-score &lt;−2. p&lt;0.05 was considered statistically significant. Results: We report a 15.7% prevalence of stunting in our cohort of children with T1D. Stunted children had higher cholesterol, lower hemoglobin, lower mid-parental height Z-scores, and higher urinary albumin creatinine ratio. Binary logistic regression revealed that pre-existing comorbidities, compromised renal function, longer disease duration, and short mid-parental height were significant predictors of stunting. Conclusion: A little under one-sixth of children with T1D had short stature. Monitoring growth in these patients, especially in subjects with short parents, prolonged duration of diabetes, existing comorbidities, and deteriorating renal function are critical.

Paediatric dominant and non-dominant handgrip reference curves and the association with body composition

Background Lack of paediatric reference data limits the utility of handgrip strength as a measure of fitness and well-being. Aim To develop paediatric handgrip reference curves and evaluate associations with body size and composition and race/ethnicity group. Subjects and methods Handgrip, body size and composition data were obtained from National Health and Nutrition Examination Survey 2011–2014 participants aged 6–20 years. Densitometry-derived fat and appendicular lean soft tissue mass index Z-scores (FMIZ, ALSTMIZ) were generated in participants >8 years. Dominant and non-dominant handgrip reference curves were created using the LMS method. Analyses included sample weights to produce nationally representative estimates. Results Differences in handgrip strength according to hand dominance increased with age. Handgrip strength was associated with height and arm length Z-scores (R = 0.42 to 0.47) and ALSTMIZ (R = 0.54). Handgrip strength was higher in the non-Hispanic Black group and lower in the Mexican American compared to non-Hispanic White group. Group differences were attenuated when adjusted for height, arm length or ALSTMIZ. Conclusion Paediatric handgrip reference curves were generated from which individual Z-scores can be calculated separately for dominant versus non-dominant hand and adjusted for body size. Association with ALSTMIZ suggests handgrip Z-score may be used as a measure of functional body composition.

Disease Manifestations and Complications in Dutch X-Linked Hypophosphatemia Patients

X-linked hypophosphatemia (XLH) is the most common monogenetic cause of chronic hypophosphatemia, characterized by rickets and osteomalacia. Disease manifestations and treatment of XLH patients in the Netherlands are currently unknown. Characteristics of XLH patients participating in the Dutch observational registry for genetic hypophosphatemia and acquired renal phosphate wasting were analyzed. Eighty XLH patients, including 29 children, were included. Genetic testing, performed in 78.8% of patients, showed a PHEX mutation in 96.8%. Median (range) Z-score for height was − 2.5 (− 5.5; 1.0) in adults and − 1.4 (− 3.7; 1.0) in children. Many patients were overweight or obese: 64.3% of adults and 37.0% of children. All children received XLH-related medication e.g., active vitamin D, phosphate supplementation or burosumab, while 8 adults used no medication. Lower age at start of XLH-related treatment was associated with higher height at inclusion. Hearing loss was reported in 6.9% of children and 31.4% of adults. Knee deformities were observed in 75.0% of all patients and osteoarthritis in 51.0% of adult patients. Nephrocalcinosis was observed in 62.1% of children and 33.3% of adults. Earlier start of XLH-related treatment was associated with higher risk of nephrocalcinosis and detection at younger age. Hyperparathyroidism longer than six months was reported in 37.9% of children and 35.3% of adults. This nationwide study confirms the high prevalence of adiposity, hearing loss, bone deformities, osteoarthritis, nephrocalcinosis and hyperparathyroidism in Dutch XLH patients. Early start of XLH-related treatment appears to be beneficial for longitudinal growth but may increase development of nephrocalcinosis.

Growth development of children and adolescents with inflammatory bowel disease in the period 2000–2014 based on data of the Saxon pediatric IBD registry: a population-based study

BackgroundThe incidence of inflammatory bowel disease (IBD) in children is on the increase worldwide. Growth disorders are common in pediatric patients with inflammatory bowel disease. The aim of this paper is to investigate anthropometric indicators, including height and weight in children with inflammatory bowel disease in Saxony, one of the German federal states, and to evaluate growth trends in patients by comparing their height and weight with that of healthy children in Germany.MethodsIn Saxony, all children and adolescents with IBD were registered in the Saxon Pediatric IBD Registry from 2000 to 2014. The data used are therefore based on a total area-wide survey over 15 years. For this study, 421 datasets of children and adolescents aged 0–14 years with Crohn’s disease (CD) (n = 291) or ulcerative colitis (UC) (n = 130) were analyzed.Z-score and percentile calculations were used to compare differences between IBD patients and the general population.ResultsThe children with CD or UC (both sexes) had a significant lower weight at diagnosis (the mean weight z-score had negative values) versus the general population. The weight values lay mostly below P50 (the 50th percentile, median), more precisely, mostly between P10 and P50 of the body weight child growth curve for corresponding sexes (KiGGS 2003–2006).The height values of both sexes at diagnosis lay also mostly below P50 (the 50th percentile, median) of the child body growth curve for corresponding sexes (KiGGS 2003–2006), i.e. the mean height z-score was negative. But only the children with CD had a significant lower height, more precisely, mostly between P25 and P50 versus the general population (KIGGS). For children with UC the difference was not significant.ConclusionIn pediatric patients with IBD the possibility of growth disturbance, mainly in the form of weight retardation, is very probable.

Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation.

To evaluate the prevalence of vertebral fracture (VF) in children with chronic liver disease (CLD) with and without liver transplantation (LT) and to determine the associated factors. A cross-sectional study was conducted. Patients aged 3-21 years with CLD both before and after LT were enrolled in the study. Lateral thoracolumbar spine radiographs were obtained and assessed for VF using Mäkitie's method. Clinical and biochemical data were collected. We enrolled 147 patients (80 females; median age 8.8 years [interquartile range 6.0-11.8]; 110 [74.8%] in the LT group and 37 [25.2%] in the non-LT group). VF was identified in 21 patients (14.3%): 17/110 (15.5%) in the LT group and 4/37 (10.8%) in the non-LT group (p=0.54). Back pain was noted in only three patients with VF. In the univariate analysis, a height z-score below -2.0 (p=0.010), pre-LT hepatopulmonary syndrome (p=0.014), elevated serum direct and total bilirubin levels (p=0.037 and p=0.049, respectively), and vitamin D deficiency at 1-year post-LT (p=0.048) were associated with VF in the LT group. In multivariate analysis, height z-score below -2.0 was the only significant associated factor (odds ratio, 5.94; 95% confidence interval, 1.49-23.76; p=0.012) for VF. All VFs in the non-LT group were reported in males. In children with CLD, VF is common before and after LT. Most patients with VF are asymptomatic. Screening for VF should be considered in patients with a height z-score below -2.0 after LT.

Effects of Cucurbita Moschata squash (Butternut) seed paste in improving zinc and iron status in children attending Early Childhood Development centres in Limpopo province, South Africa.

Cucurbita moschata (Butternut squash) seeds are a rich source of nutrition containing nutrients including iron, zinc, copper, calcium, potassium, and phosphorus. The aim of this study was to determine if Cucurbita Moschata squash seed paste improves zinc and iron status, anthropometric status, and dietary intake in preschool children. A pretest-posttest control group trial using cluster randomisation was conducted over 6 months. Four preschools were randomly assigned to receive 100 g of intervention or 100 g of a placebo as the control to enhance iron and zinc status. A total of 276 preschool children were recruited from eight government registered Early Childhood Development centres in Limpopo province, South Africa. The control group consumed Cucurbita moschata flesh twice-weekly, while the intervention group consumed Cucurbita moschata seed paste twice-weekly during a six-month period. Iron (serum iron, transferrin, transferrin saturation, ferritin) and zinc (serum zinc) status and anthropometric indices such as weight, height and mid upper arm circumference for children were evaluated at baseline and the endpoint. Iron and zinc-rich food consumption was measured using a 24-hour dietary recall and food record during the study, and dietary intake was estimated using a food frequency questionnaire which was conducted at the beginning and endpoint. The intervention group significantly improved in the mean serum iron 0.23 μg/dL (95% CI: 0.11;0.33); ferritin 0.21μg/dL (95% CI: 0.13;0.39), transferrin saturation 0.33% (0.23;0.74) and zinc 0.16 μmol/dl (95% CI: 0.13;0.25) at the end of the study. In addition, the intervention group exhibited greater mean weight for age of 0.13 z-score (95% CI: 0.28; 0.34) and weight for height of 0.04 z-score (95% CI: 0.12,0.05), as well as the consumption of iron (p < 0,001), zinc (p < 0,001), and vitamin C (p < 0.001). At the end of the trial, fiber (p < 0.001), riboflavin (p = 0.001), vitamin B6 (p < 0.001), and vitamin B12 (p < 0.001) were significantly higher in the control group. Thus, the inclusion of intervention in the diet of children in an impoverished area of South Africa improved the iron and zinc status of these children. This supplement could be a cost effective and sustainable approach to improve nutrient status in rural South Africa. Trial registration: Pan African Clinical Trial Registry (PACTR202308740458863).

SANITATION AND FAMILY ENVIRONMENTAL HEALTH STATUS AND ITS ASSOCIATION WITH STUNTING IN KULON PROGO, INDONESIA

Stunting remains prevalent in Indonesia. The indicators of the family's health were related with an unhealthy sanitation cause affect health and nutritional problems. This risk factor can affect the family to have stunting children. Objectives: The aim of this study was to analyze the relationship of family environmental sanitation status with stunting status in Kulon Progo. Methods: The Case-control study was conducted in 240 children with 80 cases (stunting) and 160 control (not stunting) groups, respectively. The subjects were 6-59 months and taken by purposive sampling technique in the public health center of Temon 2 in Kulon Progo, Indonesia. Stunting was assessed by z-score height for age which analyzed by WHO Anthro. Structured questionnaires were created to assess anthropometry, characteristics, and sanitation status in the household. A Chi-square test was used to analyze the data. Results: There was a relationship between family environment sanitation status and the incidence of stunting among subjects (p = 0.046; OR = 1.7; 95% CI = 1.01-2.99). Clean water availability in the households associated with the high risk of the children had stunting status (p = 0.012; OR = 2.1; 95% CI = 1.20-3.62). However, the other sanitation facilities such as a healthy latrine, trash can, and sewerage system had no association with the stunting risk in the household (p&gt;0.05). Conclusion: This study found that if the families had not met the requirement of having clean water availability, they would have two times increase the risk of their children has stunting status.

Health Problems and Nutritional Status among Children Under-Five Years in Diocese of Agats: A Cross-Sectional Study

From September to February 2018, the number of measles and under-nutrition cases among children under five years in Agats reached a peak of 651 cases and 223 cases, respectively. It was reported that measles and undernutrition were responsible for 91% of child mortality in Agats. This study aimed to identify the correlation between health problems with nutritional status among children under five in the Diocese of Agats, Asmat. A descriptive quantitative with a cross-sectional approach was conducted from May to September 2018 among 39 mothers and 53 children. Data were collected by using an attendance list that consisted of mother and child characteristics, nutritional status was measured by using steelyard balance and microtoise, and the results would subsequently be converted to the standardized anthropometry: Weight for Age Z-score (WAZ) and Weight for Height Z-Score (WHZ). Results revealed that child health problems were cough and influenza (28%), febrile (1,9%), and itches (3,8%) while the nutritional status categorized normal (43.3%), underweight (33.1%), and waste (23.3%). ChiSquare test found that there was a significant correlation between health problems and nutritional status of children under-five (p-value: 0,035; CI 95% = 0,68 – 0,79). It is concluded that health problems are associated with nutritional status among children under five. It is recommended that regular health promotion to improve mothers’ knowledge should be conducted by healthcare workers, volunteers, teachers, stakeholders, and the local government of Asmat Regency.

The Relationship Between Anthropometric Z-Score Measurements and Ocular Structures in Turkish Children.

Objective (Aim): This study explores the contact between anthropometric Z-score values and ocular parameters in children. Recent studies investigated the relationship, and contact between anthropometric measurements and ocular parameters in children, and height, weight, body mass index, and percentile curves are mostly used as anthropometric data. However, today, different scoring systems such as "Z-score" classify anthropometric values. Methods: Height and body mass index Z-scores were calculated for 725 children. Biometric and refractive measurements of all children were noted. For different reference values, those with a Z-score below the negative value of the reference were defined as a low Z-score, those between the negative and positive value of the reference were defined as a normal Z-score, those with a Z-score greater than the positive value of the reference were defined as a high Z-score. The mean ocular measurement results in the low, normal, and high Z-score groups were compared, and they were pointed to reach the reference value in both negative and positive sides which created the foremost critical contrast between the groups. Results: For a value of "-1" and "+1.5" in the height Z-score, from low to normal and from there to high Z-score group, axial length, and average corneal radius increased, and average corneal power decreased significantly. Anterior chamber depth increased from normal to high Z-score group, but no critical distinction was made between low and normal Z-score groups. Moreover, no critical distinction was observed in spherical equivalent refraction, central corneal thickness for height, and all values of body mass index. Conclusion: Considering a Z-score value of "-1" and "+1.5" as a reference value in children and anticipating the changes that may happen in the ocular structures of children at both ends of the Z-score, it may be useful to understand the effect of body development on ocular development more. Abbreviations: AL = Axial Length, ACD = Anterior Chamber Depth, BMI = Body Mass Index, NCHS = The United States National Center for Health Statistics, WHO = World Health Organization, NFHS 2 = National Family Health Survey 2, SER = Spherical Equivalent Refraction, CR = Average Corneal Radius, CP = Average Corneal Power, CCT = Central Corneal Thickness, HFAsZ = Height for Age Z-Score, BMIsZ = BMI for Age Z-Score, L = Low Z-score, N = Normal Z-score, H = High Z-score.

Longitudinal assessment of auxological parameters, adult height outcome and its determinants in leuprolide-treated Indian girls with idiopathic central precocious puberty.

To assess auxological parameters, adult height outcome and its determinants in Indian girls with idiopathic central precocious puberty (iCPP) treated with gonadotropin-releasing hormone analogues (GnRHa). Retrospective study. Inclusion: data on girls with iCPP from initiation to stopping GnRHa (n=179). Exclusion: boys, peripheral, organic central precocity. Mean age of starting GnRHa: 8.2± 1.1 years, duration: 2.8± 1.2 years. 11.7 % had attained menarche at first presentation. The difference between bone (BA) and chronological (CA) ages reduced significantly from 2.6± 0.9 years (onset) to 1.6± 0.8 years (cessation). Weight, BMI Z-scores increased (p<0.01), height Z-scores decreased (0.8 vs. 0.6; p<0.01), predicted adult height (PAH) and Z-scores improved by 3.5 cm, 0.5 SDS following treatment (p<0.01). Overweight/obese girls (vs. normal BMI) were taller, with more advanced BA at starting (height Z-score: 0.7 vs. 1.0, BA-CA: 2.2 vs. 2.9 years), stopping (height Z-score: 0.5 vs. 0.9, BA-CA: 1.4 vs. 1.9 years) treatment, but showed no difference in PAH at starting, stopping treatment. Adult height data (n=58) revealed 1.9 cm gain above target height. Adult height Z-scores significantly exceeded target height Z-scores (p<0.01). Mean adult height (157.1± 5.8 cm) crossed PAH at starting treatment (155.9± 6.4 cm) but remained 1.6 cm lesser than PAH at cessation. Adult weight, BMI Z-scores (-0.2± 1.3,-0.1± 1.2) were significantly lower (p<0.01) than those at stopping GnRHa. Height gain adjusted for age at starting GnRHa correlated negatively with height, weight, BMI, Tanner-staging, BA, FSH, Estradiol at treatment onset, BA at cessation, and correlated positively with treatment duration. GnRHa treatment in Indian girls with iCPP resulted in improved PAH, decelerated bone age advancement and growth velocity. Most girls achieved adult height within target range, surpassing PAH at treatment initiation. Lesser anthropometric, sexual, skeletal maturity, lower baseline FSH, estradiol, longer treatment duration, less advanced BA at stopping GnRHa may translate into better adult height outcomes.

Demographic, Clinical, and Laboratory Characteristics of Children with Renal Tubular Acidosis

This study included patients followed up for primary renal tubular acidosis (RTA) between 1991 and 2012. Clinical characteristics at presentation, physical examination findings, laboratory test results, and treatments were recorded. The patients’ laboratory results, drug doses, height, and weight were recorded every 3 months for the first year of follow-up. Standard deviation scores (Z-scores) of height and weight for age were determined and the patients’ growth rates were evaluated. Of 50 patients followed up for primary RTA, 31 (62%) had distal RTA and 19 (38%) had proximal RTA. The median age at diagnosis was 3 months (range, 1-174 months) for patients with distal RTA and 10 months (range, 2-33 months) for patients with proximal RTA. The median follow-up times in these two groups were 96 months (range, 6-204 months) and 89 months (range, 6-180 months), respectively. Family history of RTA was more common among patients with distal RTA than those with proximal RTA (p=0.013). Nephrocalcinosis and deafness were detected more frequently in the distal RTA group (p=0.001), while ocular pathologies were more common in the proximal RTA group (p&lt;0.001). In patients with distal RTA, older age at diagnosis was associated with lower weight and height Z-scores (p&lt;0.05). Early diagnosis had a positive effect on the growth of patients with primary RTA.

FACTORS RELATED TO THE INCIDENT OF STUNTING (ECONOMIC STATUS AND EXCLUSIVE BREASTFEEDING) IN TODDLER AGE 25-59 MONTHS

Stunting is one of the problems that hampers human growth and development globally and is a form of malnutrition which is marked by the Z-score of height for age (TB/U). community-based on monthly income, which usually affects the incidence of stunting. In addition, exclusive breastfeeding is only breastfeeding for babies from birth to 6 months of age without being given other food and drinks. The purpose of this study was to determine the relationship between economic factors and exclusive breastfeeding for stunting toddlers aged 25-59 months in the Awangpone District in 2021. This research method used the accidental sampling method according to the inclusion criteria. There are 80 respondents obtained from the results of the chi-square statistical test analysis showing that there is a significant relationship between economic status and exclusive breastfeeding on the incidence of stunting with p = 0.003 and p = 0.002

Factors associated with pubertal growth outcomes in cystic fibrosis: Early Growth and Puberty in CF

BackgroundPubertal delays in children with cystic fibrosis (CF) have historically been common. It is unclear to what degree puberty is affected in the new era of CF care or the role of early nutritional status. We hypothesized that more favorable early growth trajectories are associated with improved pubertal growth outcomes. MethodsWe used data from the United States CF Foundation Patient Registry to analyze associations between early weight-for-length/body mass index (WFL-BMI) growth trajectories and pubertal outcomes, using peak height velocity (PHV) and age at PHV (APHV) as proxy measures for puberty in addition to adult height (defined as height at age 18 years). Our analysis consisted of shape invariant mixed modeling and multivariable linear regression. ResultsOur sample consisted of 9,186 people with CF aged 18 to 21 years between 2010-2019. APHV was earliest and PHV/adult height were highest in those with WFL-BMI always >50th percentile from 0-6 years. However, there was no difference after adjusting for key covariates. Receiving CF transmembrane conductance regulator (CFTR) modulator therapy in childhood was associated with being taller at 18 years, by 0.92 cm in males (p=0.048) and 1.02 cm in females (p=0.010) in adjusted models. Higher height z-score at 2 years was associated with improved APHV and PHV for males and improved adult height for both males and females (p<0.001) in adjusted models. ConclusionsEarly height, but not early WFL-BMI trajectories, may be associated with pubertal growth outcomes. CFTR modulator therapy shows the potential to improve pubertal growth outcomes, but further research is necessary.

Early weight measures and long-term neuropsychological outcome of critically ill neonates and infants: a secondary analysis of the PEPaNIC trial

Neonates and infants surviving critical illness show impaired growth during critical illness and are at risk for later neuropsychological impairments. Early identification of individuals most at risk is needed to provide tailored long-term follow-up and care. The research question is whether early growth during hospitalization is associated with growth and neuropsychological outcomes in neonates and infants after pediatric intensive care unit admission (PICU). This is a secondary analysis of the PEPaNIC trial. Weight measurements upon PICU admission, at PICU discharge, at hospital discharge, at 2- and 4-year follow-up, and of different subgroups were compared using (paired) t-tests. Multiple linear regression analyses were performed to investigate the association between early growth in weight measures and neuropsychological outcomes at 4-year follow-up. One hundred twenty-one infants were included, and median age upon admission was 21 days. Growth in weight per week was less than the age-appropriate norm, resulting in a decrease in weight-for-age Z-score during hospitalization. Weight is normalized at 2- and 4-year follow-up. Weight gain in kilograms per week and change in weight Z-score were not associated with neurodevelopmental outcome measures at 4-year follow-up. Lower weight-for-age Z-score at PICU admission and at hospital discharge was associated only with lower weight and height Z-scores at 4-year follow-up.Conclusion: Growth in weight during hospital stay of young survivors of critical illness is impaired. Worse early growth in weight is associated with lower weight and height but not with neuropsychological outcomes at 4-year follow-up.What is Known:• Critically ill neonates and infants show impaired early growth during admission and are at risk for later neuropsychological impairments.• Unraveling the association between early growth and later neuropsychological impairments is crucial since the first year of life is critical for brain development.What is New:• Critically ill neonates and infants had age appropriate weight measures at 4-year follow-up.• Poor growth in weight during hospital stay was not associated with poorer cognitive, emotional, or behavioral functioning four years after critical illness.

Kejadian Stunting Berdasarkan Jenis Kelamin Dan Usia Di Wilayah Kerja Puskemas Kalisat

Stunting is a chronic condition characterized by the poor condition of the child or the inhibition of the child's linear growth due to the accumulation of various factors that occur over a long time. This situation can be seen based on the z-score of height according to age less than -2 standard deviation (SD) which is classified as short and very short. To find out the incidence of stunting by gender and age in the working area of the Kalisat Health Center in 2020. Descriptive research using secondary data from patient KIA data in February 2020. From the research that has been done, it can be concluded that the incidence of stunting in toddlers is mostly male and toddlers aged 24-36 months.