Mother Height Research Articles

Determinants of 6-24 Months Child Stunting in South Central Timor District, East Nusa Tenggara Province

Nutritional problems in children under five are still a public health problem if the prevalence of stunting is> 20%. The prevalence of stunting in general in the world is also a public health problem because it is still 26%. Nationally, the prevalence of stunting in children under five in Indonesia is 37.2%. This means that the problem of nutrition in Indonesia is still a serious public health problem. Meanwhile, the proportion of children under five with stunting is 48.2% in NTT Province, including a critical public health problem. Based on this background, this study aims to determine the determinants of stunting of children 6-24 months in South Central Timor District, East Nusa Tenggara Province. B This research is an observational study with a cross-sectional design. The research was carried out in nine sub-districts of Timor Tengah Selatan Regency. Baduta food consumption data were obtained through consumption recall, while other data were obtained through questionnaires by enumerators. Analysis of nutrients in food using a food processor 2 (FP2). The statistical test used is Chi-Square. The number of respondents studied was 3480 children, with stunting and severe stunting as many as 1416 children (40.7%), most of whom were boys, as many as 1870 children (53.7%), for 12-24 months there were 1916 children, (1%), where the results of the chi square test are significant p <0.05. Education of mothers and fathers, respectively 1827 people (52.5%) and 1754 people (50.4%) with basic education did not complete and graduated from junior high school, with the majority of jobs being mother farmers (83.3%) and fathers (65.0%), most of the socio-economic conditions are low (83.5%). Maternal TB was significant (p = 0.000) as well as parity and birth spacing, the results of the chi-square test were significantly significant, p <0.005, while exclusive breastfeeding was only 596 people (17.1%). Nutritional needs did not reach the Recommended dietary allowance. (RDA) <80% RDA, energy intake (90.3%), protein (82.6%), fat (97.9%) and KH (82.0%). History of diarrhea (17.4%), fever (32.6%), shortness of breath (2.3%), cough (31.0%) and runny nose (29.2%) and the results of the chi-square test were only fever. Significant with p = 0.016. The logistic regression results showed that gender and maternal height were the most associated with stunting nutritional status. The determinant factors of stunting were the child's age, sex, mother's education, maternal occupation, mother's height, parity, birth spacing, protein intake and a history of fever.

Iron Deficiency, Anemia, and Low Vitamin B-12 Serostatus in Middle Childhood Are Associated with Behavior Problems in Adolescent Boys: Results from the Bogotá School Children Cohort

Iron deficiency (ID) in infancy is related to subsequent behavior problems. The effects of micronutrient status in middle childhood are uncertain. The aim of the study was to examine the associations of micronutrient status biomarkers in middle childhood with externalizing and internalizing behavior problems in adolescence. We assessed whether ID (ferritin <15 µg/L), anemia (hemoglobin <12.7 g/dL), or blood concentrations of zinc, vitamins A and B-12, and folate at ages 5-12 y were associated with externalizing or internalizing behavior problems in adolescence in 1042 schoolchildren from Bogotá, Colombia. Behavior problems were assessed with the Youth Self-Report questionnaire after a median 6.2 y of follow-up. Mean problem score differences with 95% CIs were estimated between categories of micronutrient status biomarkers with the use of multivariable linear regression. Mean±SD externalizing and internalizing problems scores were 52.6±9.6 and 53.8±9.9, respectively. Among boys, middle-childhood ID, anemia, and low plasma vitamin B-12 were associated with 5.9 (95% CI: 1.0, 10.7), 6.6 (95% CI: 1.9, 11.3), and 2.7 (95% CI: 0.4, 4.9) units higher mean externalizing problems scores in adolescence, respectively-after adjustment for baseline age, time spent watching television or playing video games, mother's height, and socioeconomic status. Also in boys, ID was related to an adjusted 6.4 (95% CI: 1.2, 11.6) units higher mean internalizing problems score. There were no associations among girls. Other micronutrient status biomarkers were not associated with behavior problems. ID, anemia, and low vitamin B-12 in middle childhood are related to behavior problems in adolescent boys.This study was registered at clinicaltrials.gov as NCT03297970.

Tanner's Target Height Formula Underestimates Final Height in Asian Indians - A Cross-sectional Observational Study.

Introduction:Target height (TH) calculation by Tanner's formula has been shown to be inaccurate in many countries However, there is no published data on the accuracy of TH calculation by Tanner's formula in Indians. Hence, this study was conducted to assess whether Tanner's TH formula is an accurate tool to predict final height in Asian Indian population and to identify new TH formulae or models to better fit Indian population.Material and Methods:This is a cross-sectional, questionnaire-based study conducted in a tertiary care hospital from South India. A total of 396 questionnaires were randomly distributed to undergraduate medical students who were instructed beforehand to get their heights and heights of their parents and siblings between the age of 18 to 24 years of age measured by a nearby pediatrician. From 396 questionnaires, data of 481 young adults and their parents were obtained. Target height was calculated by Tanner's formula and compared with attained height.Results:The study comprised of 197 males and 284 females. Sons and daughters were 2.34 ± 7.19 cm and 1.58 ± 5.68 cm taller than TH. Son's height had best correlation with TH (r = 0.408), whereas daughter's height had best correlation with maternal height (r = 0.560). Both males (0.263 vs 0.365) and females (0.319 vs 0.560) had relatively weaker correlation with paternal heights than maternal heights. Target height explained 29.7% and 16.7% of variance in daughter's and son's height, respectively. Using the parental heights as variables, multiple regression yielded 50.03 + 0.172 (father's height) +0.510 (mother's height) and 74.09 + 0.236 (father's height) +0.377 (mother's height) as the best models to predict daughter's and son's height, respectively.Conclusion:Our study suggests that Tanner's TH formula underestimates final attainable height in Asian Indians.

Catch-up growth in stunted children: Definitions and predictors.

This paper examines the incidence and correlates of linear growth catch up in early childhood among stunted children, using a range of definitions of catch up. Catch-up growth between two and five years of age is defined in both absolute terms (i.e. the centimetre height deficit from the healthy reference population mean is reduced) and relative terms (the height-for-age z-score improved or passed the -2SD or -1SD cut-off points). Data from a cohort study from urban South Africa are used to estimate the percentage of children who caught up and the predictors of catch-up growth according to these varying definitions. The results show that our sample of stunted children exhibits catch-up growth regardless of the definition used, however prevalence of catch up is highly sensitive to the way catch up is classified, ranging from 19%-93%. Of the biological, early growth, socioeconomic status and maternal reproductive variables included in the multivariate probit regressions, only a few were found to be consistent predictors of the incidence of catch-up growth. Mother’s height was positively correlated with the incidence of catch-up growth and early stunting at one year was associated with a lower likelihood of subsequent catch up.

Pregnancy outcome variables and associated factors in different nationalities living in Kuwait.

This study aimed to investigate differences in pregnancy outcome among various nationalities residing in Kuwait. Cross-sectional data were collected from 369 mother-infant dyads at delivery on mother height (MH), mother haemoglobin (mHb), child haemoglobin (cHb), mid-upper arm circumference (MUAC), gestational age (GA), placental weight (PW), birth weight (BW), crown-heal length (CHL), and head circumference (HC). Significant differences among various nationalities were observed in mHb, HC, CHL, PW and MH. Kuwaiti and Indian women had lower PW and their babies had lower HC and CHL. Prevalence of anaemia (Hb <11.0 g/dL) ranged from 7.1% (Lebanese) to 30.0% (Kuwaiti) with the overall prevalence of 19.5%. Prevalence of low birth weight was 3.5%. Multiple linear regression analysis revealed PW as a significant predictor of BW, CHL and HC. Significant differences among various nationalities were observed in mHb, HC, CHL, PW and MH.The significance of these differences and their contributing factors needs further research.

Growth recovery and faltering through early adolescence in low- and middle-income countries: Determinants and implications for cognitive development

Child chronic undernutrition, as measured by stunting, is prevalent in low- and middle-income countries and is among the major threats to child development. While stunting and its implications for cognitive development have been considered irreversible beyond early childhood there is a lack of consensus in the literature on this, as there is some evidence of recovery from stunting and that this recovery may be associated with improvements in cognition. Less is known however, about the drivers of growth recovery and the aspects of recovery linked to cognitive development. In this paper we investigate the factors associated with growth recovery and faltering through age 12 years and the implications of the incidence, timing, and persistence of post-infancy recovery from stunting for cognitive development using longitudinal data from Ethiopia, India, Peru, and Vietnam. We find that the factors most systematically associated with accelerated growth both before and after early childhood and across countries include mother's height, household living standards and shocks, community wages, food prices, and garbage collection. Our results suggest that post-infancy recovery from stunting is more likely to be systematically associated with higher achievement scores across countries when it is persistent and that associations between growth trajectories and cognitive achievement in middle childhood do not persist through early adolescence across countries. Overall, our findings indicate that growth after early childhood is responsive to changes in the household and community environments and that growth promotion after early childhood may yield improvements in child cognitive development.

Calculation of optimal gestation weight gain in pre-pregnancy underweight women due to body mass index change in relation to mother's height.

Optimal gestational weight gain has not yet been clearly defined and remains one of the most controversial issues in modern perinatology. The role of optimal weight gain during pregnancy is critical, as it has a strong effect on perinatal outcomes. In this study, gestational body mass index (BMI) change, accounting for maternal height, was investigated as a new criterion for gestational weight gain determination, in the context of fetal growth assessment. We had focused on underweight women only, and aimed to assess whether the Institute of Medicine (IOM) guidelines could be considered acceptable or additional corrections are required in this subgroup of women. The study included 1205 pre-pregnancy underweight mothers and their neonates. Only mothers with singleton term pregnancies (37th-42nd week of gestation) with pre-gestational BMI<18.5kg/m2 were enrolled. The share of small for gestational age (SGA) infants in the study population was 16.2%. Our results showed the minimal recommended gestational weight gain of 12-14kg and BMI change of 4-5kg/m2 to be associated with a lower prevalence of SGA newborns. Based on our results, the recommended upper limit of gestational mass change could definitely be substantially higher. Optimal weight gain in underweight women could be estimated in the very beginning of pregnancy as recommended BMI change, but recalculated in kilograms according to body height, which modulates the numerical calculation of BMI. Our proposal presents a further step forward towards individualized approach for each pregnant woman.

Birth Size, Stunting and Recovery from Stunting in Andhra Pradesh, India: Evidence from the Young Lives Study.

Objectives Few Indian studies have examined the relationship between birth size and stunting in children. Studies on recovery from stunting in India are even fewer. This study, thus, investigates the relationship between birth size and stunting in Andhra Pradesh, India. This study further examines the factors associated with recovery from stunting using a longitudinal data. Methods We used data from the three waves of Young Lives Study (YLS) conducted in Andhra Pradesh in the years 2002, 2006-2007, and 2009 respectively. We used data from 1965 children in wave 1 to examine the association between birth size and stunting. For examining the factors associated with recovery from stunting between 1 and 5years of age, and between 5 and 8years, we use data from 582 and 670 children who were stunted at age 1 and age 5 respectively. We use multivariable logistic regression models to fulfil the objectives of the paper. Results The children who were of average- or large- size at birth were significantly less likely to be stunted than children who were of small size at birth (OR 0.61 and 0.47 respectively). Children of average/tall mothers were 0.41 times less likely to be stunted than children of shorter mothers. Severely stunted children were less likely than other stunted children to recover from stunting between 1 and 5years of age, and between 5 and 8years. Mother's height was statistically associated with recovery. Change in wealth status of the household was statistically associated with recovery between 1 and 5years of age. In comparison, child immunization was associated with recovery between 5 and 8years. Conclusions for Practice This study contributes to the understanding of the impact of birth size on childhood stunting, and to the extent of recovery from stunting in India. Further follow-up is necessary to demonstrate the impact during adolescence and adulthood.

Determinants of stunting reduction in Ethiopia 2000 - 2011.

The prevalence of stunting in Ethiopia declined from 57% in 2000 to 44% in 2011, yet the factors producing this change are not fully understood. Data on 23,999 children 0-59 months of age from three Demographic and Health Surveys (DHS) from 2000, 2005, and 2011 were analyzed to assess the trends in stunting prevalence, mean height-for-age z-scores (HAZ) and the associations between potential factors and HAZ. Associations were determined separately using three separate generalized linear models for children age less than 6 months, 6-23 months, and 24-59 months of age. Significant variables were then analyzed to determine if they showed an overall trend between the 2000 and 2011 surveys. In children < 6 months of age, only mother's height was both a significant predictor of HAZ and showed a progressive, albeit non-significant, increase from 2000 to 2011. In children 6-23 months of age, only mother's use of modern contraception showed substantial changes in a direction consistent with improving HAZ, but improvements in maternal nutrition status were observed from 2000 to 2005. For children 24-59 months of age a consistent and progressive change is seen in child's diarrhea, fever, mother's education, and the occurrence of open defecation. Our analysis demonstrated that factors associated with HAZ vary by child's age and the dominant livelihood practice in the community. Variables that could have contributed to the decline of stunting in Ethiopia in children less than 5 years of age include markers of child health, mother's nutritional status, mother's educational level, and environmental hygiene.

Effects of initial body mass index on development of gestational diabetes in a rural Sri Lankan population: A case-control study

AimHigh pre-pregnancy body mass index (BMI) and excessive pregnancy weight gain lead to higher incidence of gestational diabetes mellitus (GDM). Aim of the study was to assess the effects of initial BMI and pregnancy weight gain on development of GDM in a rural Sri Lankan population. It was also hypothesized that these effects could be more pronounced in shorter mothers. MethodsA case-control study was conducted at two rural hospitals in Sri Lanka. A case was defined as a pregnant mother admitted for the completion of pregnancy and diagnosed to have GDM (n=99). A similar group of mothers without GDM were recruited as controls (n=336). Data were collected through health records and direct interviews. ResultsMean age of GDM and non-GDM mothers were 32.8 years 28.1 years, respectively. High pre-pregnancy BMI was a significant risk for GDM, with a rising trend with increasing BMI. In contrast to underweight mothers, the risk increases from normal weight [odds ratio (OR)=6.6, 95% confidence interval (CI) 2.2–19.4, p<0.01], overweight (OR=17.1, 95% CI 5.8–49.9, p<0.01) and to obese (OR=32.4, 95% CI 10.0–104.5, p<0.01). There was no significant difference in weight gain across mother's height groups. Height or leg length did not show an association with GDM. Family history of diabetes and past GDM were associated with GDM. GDM mothers had higher likelihood for cesarian deliveries, and babies with higher birth weight. ConclusionThe pre-pregnancy BMI was the most important modifiable risk factor for GDM, and it should be the main preventive measure.

Predictors of Stunting Among Children Ages 0 to 59 Months in a Rural Region of Armenia

The prevalence of stunting in Armenia more than doubled since the 1990 s. This study aimed to investigate the prevalence and the predictors of stunting among children younger than 5 years in a rural region of Armenia, Talin, targeted by the World Vision (WV) nutrition interventions. Anthropometric measurements were conducted among a large representative sample of children 0 to 59 months old to identify the prevalence of stunting. Children identified as stunted were included in a case-control study as cases and compared with normally growing controls randomly selected from the same pool of children. The mothers of cases and controls were interviewed. Logistic regression analysis was applied to identify the predictors of stunting. Of 739 measured children, 101 (13.7%) were undernourished, including 94 (12.7%) who were stunted. The fitted logistic regression model identified 7 independent predictors of stunting, of which 4 were protective: mother's height, child's birth length, number of child's hand washings per day, and the full set of WV interventions carried out in the community; whereas 3 were risk factors, that is, never/rarely using soap during hand washing, being the fourth or later child in the family, and family size. The study findings suggest that although WV nutrition interventions have shown impact, there is also a nonnutritional pathway of child stunting in rural Armenia. Thus, antistunting interventions should include sanitation and hygienic measures along with adequate perinatal care and maternal and child nutrition to further reduce childhood stunting, ensuring long-term health benefits for children not only in rural Armenia but also in rural communities in other low/middle-income countries.

Fetal growth and subsequent maternal risk of thyroid cancer

Thyroid cancer has peak incidence among women of reproductive age, and growth factors, which have procarcinogenic properties, may play an important etiologic role. However, the association between fetal growth rate during a woman's pregnancy and her subsequent risk of thyroid cancer has not been previously examined. We conducted a national cohort study of 1,837,634 mothers who had a total of 3,588,497 live-births in Sweden in 1973-2008, followed up for thyroid cancer incidence through 2009. There were 2,202 mothers subsequently diagnosed with thyroid cancer in 36.8 million person-years of follow-up. After adjusting for maternal age, height, weight, smoking, and sociodemographic factors, high fetal growth (birth weight standardized for gestational age and sex) was associated with a subsequent increased risk of thyroid cancer in the mother (incidence rate ratio [IRR] per additional 1 standard deviation, 1.05; 95% CI, 1.01-1.09; p = 0.02). Each 1,000 g increase in the infant's birth weight was associated with a 13% increase in the mother's subsequent risk of thyroid cancer (IRR, 1.13; 95% CI, 1.05-1.22; p = 0.001). These findings appeared to involve both papillary and follicular subtypes, and did not vary significantly by the mother's height, weight or smoking status. In this large national cohort study, high fetal growth during a woman's pregnancy was independently associated with a subsequent increased risk of her developing thyroid cancer. If confirmed, these findings suggest an important role of maternal growth factors in the development of thyroid cancer, and potentially may help facilitate the identification of high-risk subgroups of women.

Maternal Determinants of Birth Weight in Northern Ghana.

ObjectivesWeight at birth is usually considered as an indicator of the health status of a given society. As a result this study was designed to investigate the association between birth weight and maternal factors such as gestational weight gain, pre—pregnancy BMI and socio—economic status in Northern Ghana.MethodsThe study was a facility-based cross-sectional survey conducted in two districts in the Northern region of Ghana. These districts were purposively sampled to represent a mix of urban, peri—urban and rural population. The current study included 419 mother-infant pairs who delivered at term (37–42 weeks). Mother’s height, pre-pregnancy weight and weight changes were generated from the antenatal records. Questionnaires were administered to establish socio-economic and demographic information of respondents. Maternal factors associated with birth weight were examined using multiple and univariate regressions.ResultsThe mothers were generally well nourished before conception (Underweight 3.82%, Normal 57.76%, Overweight 25.06% and Obesity 13.37%) but approximately half of them could not gain adequate weight according to Institute of Medicine recommendations (Low weight gain 49.64%, Adequate weight gain 42.96% and Excessive weight gain 7.40%). Infants whose mothers had excess weight gain were 431g (95% CI 18–444) heavier compared to those whose mothers gained normal weight, while those whose mothers gained less were 479g (95% CI -682– (-276) lighter. Infants of mothers who were overweight and obese before conception were 246g (95% CI 87–405) and 595g (95% CI 375–815) respectively heavier than those of normal mothers, whereas those whose mothers were underweight were 305g (95% CI -565 –(-44) lighter. The mean birth weight observed was 2.98 ± 0.68 kg.ConclusionOur findings show that pre-pregnancy body mass index and weight gain during pregnancy influence birth weight. Therefore, emphasis should be placed on counseling and assisting pregnant women to stay within the recommended weight gain ranges.

Differences in pregnancy outcome and its predictors among various nationalities residing in Kuwait

We investigated differences in maternal and infant related birth variables among various nationalities residing in Kuwait and evaluated major predictors of pregnancy outcome. In a cross‐sectional study, pregnant women admitted for deliveries between 7:00 am and 7:00 pm over a three‐month period were recruited from Al‐Sabah Maternity Hospital, Kuwait. Data were collected from 369 mother‐infant dyads on mother height (MH), mother hemoglobin (mHb), child hemoglobin (cHb), mid‐upper arm circumference (MUAC), gestational age (GA), placental weight (PW), birth weight (BW), crown‐heal length (CHL), and head circumference (HC). PW/BW ratio was analyzed. Study sample comprised of 21.7% Kuwaitis, 22% Egyptians, 12.2% Indians, 11.4% Syrians, 7.6% Lebanese and 25.1% others. Significant differences among various nationalities were observed in mHb, HC, CHL, PW and MH. Kuwaiti and Indian women had lower PW and their babies had lower HC and CHL. Prevalence of anemia (Hb &lt;11.0 g/dL) ranged from 29.6% (Egyptians) to 57.5% (Kuwaiti) with the overall prevalence of 42.7%. Prevalence of low birth weight in this sample was 3.5%. Multiple linear regression analysis revealed PW as a significant predictor of BW, CHL and HC. In conclusion, significant differences among different nationalities were observed in mHb, HC, CHL, PW and MH and these differences were significantly predicted by PW and MH. The significance of these differences and their contributing factors needs further research.

The effect of one-child family on child nutrition in China

This paper examines the determinants of child nutritional status in China, focusing specially on the only-child effect. Data are drawn from China Health and Nutrition Survey, 2000. The empirical relationship between nutritional status and only-child, on the one hand, and other effect factors like mother's height, maternal education, and location (urban vs. rural) is investigated. Ordinary least squares (OLS) and Match method are used respectively. In the preferred model — Match model where a two-step match was explored — we find that being an only-child can increase the height-for-age z-scores by 0.4 ~ 0.5.

Ethnic differences in pregnancy outcome and its predictors in Kuwait (806.9)

Background: Kuwait is a multi‐ethnic society with two‐third of the population comprises expatriates of various nationalities. In this research, we evaluated the major predictors of pregnancy outcome, and tested whether there are ethnic differences in maternal variables, and infant related birth attributes.Methods: Women (n=369) admitted to the Al‐Sabah Maternity Hospital Kuwait for deliveries were recruited in this study. Data were collected on mother height (MH), hemoglobin (Hb), mid‐upper arm circumference, blood pressure, placental weight (PW), birth weight (BW), crown‐heal length (CHL), and head circumference (HC). PW/BW ratio was also calculated.Results: Linear regression analysis showed PW as a significant predictor of BW, CHL and HC and MH as a significant predictor of BW and CHL. Both PW and MH were significantly lower in Kuwaiti and Indian women compared to Egyptian, Syrian or Lebanese women. Parallel to these, Kuwaiti and Indian women had babies with significantly lower HC and CHL values. Hb was significantly lower in Kuwaiti women compared to other ethnic groups, whereas, BW did not differ significantly.Conclusion: Significant ethnic differences were observed in CHL and HC and these differences were predicted by PW and MH. Further research is needed to elucidate the significance of these differences in pregnancy outcome and factors that contribute to these differences.Grant Funding Source: Supported by KU Graduate Student Grant

Impact of an intervention nutrition program during prenatal on the weight of newborns from teenage mothers.

The nutritional care for teenage mothers had been studied as a factor that influences the course of pregnancy and neonatal outcomes, especially in birth weight. Evaluate the effect of a prenatal intervention nutrition program, with early start of the nutritional care and individualized attendance on teenage mother newborns' weight. Not randomized study of intervention performed with 746 teenage mothers (14 to 19 years old), subdivided in historic control group (GI; n= 542) and intervention group (GII; n= 204). The dependent variable was the low birth weight (LBW). The independent variables assessed were: sociodemographic (mother age, skin color, instruction level and sanitation conditions), anthropometric (mother's height, pre-gestational nutritional study and adequacy of gestational weight gain), obstetric (gestational age in first prenatal consultation, number of pregnancies, childbirths and abortions, interdelivery and inter-gestational intervals), prenatal attendance (number of prenatal and nutritional attendance consultations) and conditions of the newborn (birth weight and duration of the pregnancy). Data were analyzed by Poisson regression with robust variance. The average of maternal age at delivery was 17,5 years old (standard deviation 1,59). The percentage of LBW considerably reduced from 11,3% in GI to 2,9% in GII (p < 0,001). We observed in the multivariate model that the teenage mothers who have not received the intervention presented 3,5 more prevalence (GI, RP adjusted 3,5; IC95% 1,49-8,44) to give birth to a low weight newborn. The participation of the teenage mother in the prenatal nutrition care program proposed here contributed to the reduction of the low weight of newborns.

Is there “seasonal” variation in height velocity in children treated with growth hormone? Data from the National Cooperative Growth Study

BackgroundGrowth rate In children is reported to have seasonal variability. There are fewer published data regarding seasonal variability while on growth hormone (GH) therapy, and none analyzing growth rate with respect to number of daylight hours.MethodsWe analyzed 11,587 3-month intervals in 2277 prepubertal children (boys ages 3–14 years, girls ages 3–12 years) with idiopathic GH deficiency from the National Cooperative Growth Study (NCGS) database. All were naive to recombinant human GH (rhGH) therapy. Data were submitted from 31 US study centers. Seasonal variation in height velocity (HV) was assumed to be associated with the average number of daylight hours during the interval of time over which HV was computed. Number of daylight hours was determined from the date of the measurement and the latitude of the study center. Other independent variables evaluated included: height standard deviation score (SDS) at the beginning of the interval, chronologic age at the beginning of the interval, time from the start of rhGH treatment to the middle of the interval, month of the year, body mass index SDS at the beginning of the interval, rhGH dose/kg, mother’s height SDS, father’s height SDS, and log base 10 of the maximum stimulated GH concentration.ResultsAll variables examined, except month of the year, correlated significantly with interval HV. There was significant “seasonal” variability at all latitudes, with summer annualized HV being greater than winter HV. This difference was greatest in the first year of therapy (0.146 cm/yr/daylight hour; P < 0.0001) but persisted in subsequent years (0.121 cm/yr/daylight hr; P < 0.0001). The difference increased with distance from the equator. Growth rate over the year was not different among the latitudes reflected in this North American study.ConclusionsThere is “seasonal” variation in growth of children on rhGH therapy that correlates with number of daylight hours. The effect is modest and is greatest in the first year of therapy. Annual growth rate appears to be equal in children among latitudes covered by the US consistent with exposure to an equal number of daylight hours over the year. The physiologic mechanism behind this seasonal variation is not yet understood.

The Effect of Income on Child Nutrition in China

This study examines the determinants of child nutritional status in China, focusing specially on the household income effect. Data are drawn from China Health and Nutrition Survey, including 4 waves from 1991 to 2000. The empirical relationship between nutritional status and income, on the one hand and other effect factors like mother's height, maternal education, location (urban vs. rural, north vs. south) is investigated. Ordinary Least Squares, Random Effects, Fixed Effects and Instrumental Variables models are used, respectively. In the preferred model, a fixed effects model where income is instrumented, we find that the household income per capita shows no significant impact on the height-for-age z-scores.

Adult height of subjects with nonclassical 21‐hydroxylase deficiency

To determine whether nonclassical 21-hydroxylase deficiency (NC21OHD) compromises adult height (AH), and to establish the clinical parameters affecting AH in subjects with NC21OHD. This is a multicenter, retrospective review of medical records for clinical and biochemical parameters. The corrected height (CH) standard deviation score (SDS), defined as AH SDS minus mean parental height (MPH) SDS, was calculated for each patient, where MPH SDS is the average of the father's height SDS and the mother's height SDS. The study group consisted of 122 NC21OHD subjects whose median age at diagnosis was 8.7 years (range, 0.1-36). Seventy-two patients had two mild mutations, 22 had one mild and one severe mutation, 10 were heterozygous for one mild mutation, and 18 did not undergo molecular analysis. The CH SDS of the 66 patients who initiated hydrocortisone treatment during childhood was significantly lower than those who presented after achieving AH (p = 0.03). However, there was a negative correlation between age at diagnosis and AH SDS in the former group (R = -0.7, p = 0.03). Being heterozygous for one mild and one severe mutation (R = -0.7, p < 0.02) and age at diagnosis (R = -0.7, p = 0.03) were negatively associated with CH SDS. The CH SDS was significantly lower in those who had bone age advancement at diagnosis compared to those who did not (p = 0.04). The main determinants of AH in patients with NC21OHD are apparently age at diagnosis and initiation of therapy, and genotype. Early diagnosis and initiation of glucocorticoids therapy may improve height outcome in those presenting during childhood.