Birth-to-childhood tracking of linear growth and weight gain in the MINA-Brazil Study

B. H. Lourenço, C. Rodrigues, Ana Alice de Araújo Damasceno, M. A. Cardoso, Marcia C. Castro
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Abstract

OBJECTIVE: To investigate birth-to-childhood tracking of linear growth and weight gain across the distribution of length/height and weight for age z-scores and according to household wealth. METHODS: Data from 614 children from the MINA-Brazil Study with repeated anthropometric measurements at birth and up to age five years were used. Z-scores were calculated for length/height (HAZ) and weight (WAZ) according to international standards. Birth-to-childhood tracking was separately estimated using quantile regression models for HAZ and WAZ, extracting coefficients and 95% confidence intervals (95%CI) at the 25th, 50th, and 75th quantiles. In a subgroup analysis, we estimated tracking between birth and age two years, and between ages two and five years. To investigate disparities in tracking, interaction terms between household wealth indexes (at birth and age five years) and newborn size z-scores were included in the models. RESULTS: Tracking coefficients were significant and had similar magnitude across the distribution of anthropometric indices at age five years (HAZ, 50th quantile: 0.23, 95%CI: 0.11 to 0.35; WAZ, 50th quantile: 0.31, 95%CI: 0.19 –0.43). Greater tracking was observed between ages two and five years, with coefficients above 0.82. Significantly higher tracking of linear growth was observed among children from wealthier households, both at birth, at the lower bounds of HAZ distribution (25th quantile: 0.30, 95%CI: 0.13 – 0.56), a nd during childhood, in the entire HAZ distribution at five years. For weight gain, stronger tracking was observed at the upper bounds of WAZ distribution at age five years among children from wealthier households at birth (75th quantile: 0.59, 95%CI: 0.35–o 0.83) and during childhood (75th quantile: 0.54, 95%CI: 0.15 –0.93). CONCLUSION: There was significant tracking of HAZ and WAZ since birth, with indication of substantial stability of nutritional status between ages two and five years. Differential tracking according to household wealth should be considered for planning early interventions for preventing malnutrition.
巴西 MINA 研究中从出生到儿童期线性生长和体重增加的跟踪研究
目的:研究从出生到儿童期的线性生长和体重增加在身长/身高和体重年龄 Z 值分布中的跟踪情况,以及家庭财富情况。方法:采用巴西 MINA 研究中 614 名儿童的数据,这些儿童在出生时和五岁前均接受过重复人体测量。根据国际标准计算身长/身高(HAZ)和体重(WAZ)的 Z 值。使用量值回归模型分别估算了出生到儿童期的身高和体重跟踪,提取了第25、50和75个量值的系数和95%置信区间(95%CI)。在一项分组分析中,我们估算了出生到两岁以及两岁到五岁之间的追踪情况。为了研究追踪方面的差异,我们在模型中加入了家庭财富指数(出生时和五岁时)与新生儿体型 z 分数之间的交互项。结果:追踪系数显著,且在五岁时的人体测量指数分布中具有相似的幅度(HAZ,第 50 个数量分位数:0.23,95%CI:0.11 至 0.35;WAZ,第 50 个数量分位数:0.31,95%CI:0.19 -0.43)。两岁到五岁之间的追踪率更高,系数超过 0.82。在较富裕家庭的儿童中,无论是在出生时的 HAZ 分布下限(第 25 个数量分位数:0.30,95%CI:0.13 - 0.56),还是在童年时期的整个 HAZ 分布(5 岁时),都观察到线性增长的追踪率显著较高。就体重增加而言,在出生时来自较富裕家庭的儿童中,5 岁时在 WAZ 分布的上限(第 75 个四分位数:0.59,95%CI:0.35-0.83)和儿童期(第 75 个四分位数:0.54,95%CI:0.15-0.93)观察到较强的追踪性。结论:自出生以来,HAZ 和 WAZ 有显著的追踪,表明两岁至五岁期间的营养状况非常稳定。在规划预防营养不良的早期干预措施时,应考虑根据家庭财富情况进行差异跟踪。
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