scholarly journals Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes

2020 ◽  
Author(s):  
Nandita Perumal ◽  
Daniel E Roth ◽  
Donald C Cole ◽  
Stanley H Zlotkin ◽  
Johnna Perdrizet ◽  
...  
Keyword(s):  
A Priori ◽  
Child Growth ◽  
Model Fit ◽  
Anthropometric Indices ◽  
Childhood Growth ◽  
Growth Standards ◽  
Z Scores ◽  
Preterm Born ◽  
Epidemiology Studies ◽  
The Impact

Abstract Child growth standards are commonly used to derive age- and sex-standardized anthropometric indices but are often inappropriately applied to preterm-born children (<37 weeks of gestational age (GA)) in epidemiology studies. Using the 2004 Pelotas Birth Cohort, we examined the impact of correcting for GA in the application of child growth standards on the magnitude and direction of associations in 2 a priori–selected exposure-outcome scenarios: infant length-for-age z score (LAZ) and mid-childhood body mass index (scenario A), and infant LAZ and mid-childhood intelligence quotient (scenario B). GA was a confounder that had a strong (scenario A) or weak (scenario B) association with the outcome. Compared with uncorrected postnatal age, using GA-corrected postnatal age attenuated the magnitude of associations, particularly in early infancy, and changed inferences for associations at birth. Although differences in the magnitude of associations were small when GA was weakly associated with the outcome, model fit was meaningfully improved using corrected postnatal age. When estimating population-averaged associations with early childhood growth in studies where preterm- and term-born children are included, incorporating heterogeneity in GA at birth in the age scale used to standardize anthropometric indices postnatally provides a useful strategy to reduce standardization errors.

scholarly journals Association of Plasma Total Cysteine and Anthropometric Status in 6–30 Months Old Indian Children

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3146
Author(s):  
Catherine Schwinger ◽  
Ranadip Chowdhury ◽  
Shakun Sharma ◽  
Nita Bhandari ◽  
Sunita Taneja ◽  
...  
Keyword(s):  
Child Growth ◽  
New Delhi ◽  
Indian Children ◽  
Growth Standards ◽  
High Quality Protein ◽  
Increased Risk ◽  
Z Scores ◽  
Anthropometric Status ◽  
Height For Age

High-quality protein has been associated with child growth; however, the role of the amino acid cysteine remains unclear. The aim was to measure the extent to which plasma total cysteine (tCys) concentration is associated with anthropometric status in children aged 6–30 months living in New Delhi, India. The study was a prospective cohort study including 2102 children. We calculated Z-scores for height-for-age (HAZ), weight-for-height (WHZ), or weight-for-age (WAZ) according to the WHO Child Growth Standards. We used multiple regression models to estimate the association between tCys and the anthropometric indices. A high proportion of the children were categorized as malnourished at enrolment; 41% were stunted (HAZ ≤ −2), 19% were wasted (WHZ ≤ −2) and 42% underweight (WAZ ≤ −2). Plasma total cysteine (tCys) was significantly associated with HAZ, WHZ and WAZ after adjusting for relevant confounders (p < 0.001). Low tCys (≤25th percentile) was associated with a decrease of 0.28 Z-scores for HAZ, 0.10 Z-scores for WHZ, and 0.21 Z-scores for WAZ compared to being >25th percentile. In young Indian children from low-to-middle socioeconomic neighborhoods, a low plasma total cysteine concentration was associated with an increased risk of poor anthropometric status.

scholarly journals Child Growth Curves in High-Altitude Ladakh: Results from a Cohort Study

2020 ◽  
Vol 17 (10) ◽  
pp. 3652
Author(s):  
Wen-Chien Yang ◽  
Chun-Min Fu ◽  
Bo-Wei Su ◽  
Chung-Mei Ouyang ◽  
Kuen-Cheh Yang
Keyword(s):  
Cohort Study ◽  
High Altitude ◽  
Body Height ◽  
Child Growth ◽  
Growth Patterns ◽  
World Health ◽  
Future Research ◽  
Growth Standards ◽  
Z Scores

High prevalence of child underweight and stunting in high-altitude areas has often been reported. However, most previous studies on this topic were cross-sectional. Another critical concern is that using the World Health Organization (WHO) Child Growth Standards to evaluate child growth in high-altitude areas may lead to overestimations of underweight and stunting. Our study aimed to evaluate the long-term growth pattern of children (3 to 18 years) above the altitude of 3500 m in Ladakh, India. The participants’ body weight (BW), body height (BH), and body mass index (BMI) were measured annually according to the WHO Child Growth Standards for children under 5 years old and the WHO reference data for children aged 5 to 19 years. The generalized estimating equation (GEE) was used to estimate the means and z-scores of BW, BH, and BMI at different ages. A total of 401 children were enrolled from 2012 to 2018. Their mean z-scores of BW, BH, and BMI were −1.47, −1.44, and −0.85 in 2012 and increased to −0.74, −0.92, and −0.63 in 2018. This population’s specific growth curve was also depicted, which generally fell below the 85th percentile of the WHO standards. This is the first cohort study about long-term child growth patterns in a high-altitude area. The detailed underlying mechanisms of our findings need future research on more representative data of high-altitude populations.

Implications of the WHO Child Growth Standards in rural Honduras

2012 ◽  
Vol 15 (6) ◽  
pp. 1015-1022 ◽  
Author(s):  
Erin K Nichols ◽  
Joseph S Nichols ◽  
Beatrice J Selwyn ◽  
Carol Coello-Gomez ◽  
George R Parkerson ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Child Growth ◽  
Policy Implications ◽  
Kappa Statistics ◽  
Reference Standard ◽  
Cross Sectional ◽  
Growth Standards ◽  
Growth Reference ◽  
Who Standards ◽  
The Impact

AbstractObjectiveThe present study analysed the impact of using the 2006 WHO Child Growth Standards (‘the WHO standards’) compared with the 1977 National Center for Health Statistics (NCHS) international growth reference (‘the NCHS reference’) on the calculated prevalence of chronic malnutrition in children aged 6·0–59·9 months.DesignAnthropometric data were collected as part of a cross-sectional study exploring the association between household environments and nutritional status of children. Z-scores were computed for height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) using each reference/standard. Results were compared using Bland–Altman plots, percentage agreement, kappa statistics, line graphs and proportion of children in Z-score categories.SettingThe study was conducted in thirteen rural villages within Honduras's department of Intibucá.SubjectsChildren aged 6·0–59·9 months were the focus of the analysis, and households with children in this age range served as the sampling unit for the study.ResultsThe WHO standards yielded lower means for HAZ and higher means for WAZ and WHZ compared with the NCHS reference. The WHO standards and NCHS reference showed good agreement between Z-score categories, except for HAZ among males aged 24·0–35·9 months and WHZ among males aged >24·0 months. Using the WHO standards resulted in higher proportions of stunting (low HAZ) and overweight (high WHZ) and lower proportions of underweight (low WAZ). The degree of difference among these measures varied by age and gender.ConclusionsThe choice of growth reference/standard employed in nutritional surveys may have important methodological and policy implications. While ostensibly comparable, data on nutritional indicators derived with different growth references/standards must be interpreted cautiously.

scholarly journals Adoption of the WHO Child Growth Standards to Classify Indonesian Children under 2 Years of Age According to Nutrition Status: Stronger Indication for Nutritional Intervention

2009 ◽  
Vol 30 (3) ◽  
pp. 254-259 ◽  
Author(s):  
Madarina Julia
Keyword(s):  
Nutritional Status ◽  
Nutritional Intervention ◽  
Child Growth ◽  
World Health ◽  
Nutrition Status ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Growth Standards ◽  
Feeding Program ◽  
Z Scores

Background The National Center for Health Statistics/World Health Organization (NCHS/WHO) reference is considered unsuitable for assessing the nutritional status of breastfed children. It is gradually being replaced by the WHO Child Growth Standards in many countries. Objective To assess the implications of adopting the WHO Child Growth Standards to classify Indonesian children according to nutrition status. Methods Data were obtained from two cross-sectional surveys in two districts in Indonesia in 1998. Children under 2 years of age were randomly selected using a two-stage cluster sampling. Z-scores of weight-for-length (WLZ), length-for-age (LAZ), and weight-for-age (WAZ) were calculated based on both the NCHS/WHO reference and the WHO Child Growth Standards. Wasting, stunting, and underweight were defined as z-scores less than −2.0. Results We included 1,374 children, of whom 693 (50.4%) were male and 681 (49.6%) were female. Almost all of the children had initiated breastfeeding and were still being breastfed when the data were collected. According to the WHO Child Growth Standards, the prevalence of wasting did not change with age, but the prevalence rates of stunting and underweight rose steadily with age. Although the contribution of wasting to the classification of underweight was relatively constant, the contribution of stunting increased as the children grew. Conclusions The WHO Child Growth Standards are a better tool for assessing the nutritional status of Indonesian children than the NCHS/WHO reference. However, low WAZ is not a suitable indicator for commencing an extra feeding program, because it reflects stunting instead of wasting. The high prevalence of stunting indicates the need to perform preventive nutritional intervention beginning earlier in life, i.e., in utero.

scholarly journals The impact of optimal dating on the assessment of fetal growth

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
N. Fries ◽  
F. Dhombres ◽  
M. Massoud ◽  
J. J. Stirnemann ◽  
R. Bessis ◽  
...  
Keyword(s):  
Fetal Growth ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Low Risk ◽  
Fetal Ultrasound ◽  
Cross Sectional ◽  
Growth Standards ◽  
Z Scores ◽  
The Impact ◽  
In Pregnancy

Abstract Background The impact of using the Intergrowth (IG) dating formulae in comparison to the commonly used Robinson dating on the evaluation of biometrics and estimated fetal weight (EFW) has not been evaluated. Methods Nationwide cross-sectional study of routine fetal ultrasound biometry in low-risk pregnant women whose gestational age (GA) had been previously assessed by a first trimester CRL measurement. We compared the CRL-based GA according to the Robinson formula and the IG formula. We evaluated the fetal biometric measurements as well as the EFW taken later in pregnancy depending on the dating formula used. Mean and standard deviation of the Z scores as well as the number and percentage of cases classified as <3rd, < 10th, >90th and > 97th percentile were compared. Results Three thousand five hundred twenty-two low-risk women with scans carried out after 18 weeks were included. There were differences of zero, one and 2 days in 642 (18.2%), 2700 (76.7%) and 180 (5%) when GA was estimated based on the Robinson or the IG formula, respectively. The biometry Z scores assessed later in pregnancy were all statistically significantly lower when the Intergrowth-based dating formula was used (p < 10− 4). Likewise, the number and percentage of foetuses classified as <3rd, < 10th, >90th and > 97th percentile demonstrated significant differences. As an example, the proportion of SGA foetuses varied from 3.46 to 4.57% (p = 0.02) and that of LGA foetuses from 17.86 to 13.4% (p < 10− 4). Conclusion The dating formula used has a quite significant impact on the subsequent evaluation of biometry and EFW. We suggest that the combined and homogeneous use of a recent dating standard, together with prescriptive growth standards established on the same low-risk pregnancies, allows an optimal assessment of fetal growth.

scholarly journals Reliability and validity of the 6-item Headache Impact Test in chronic migraine from the PROMISE-2 study

2020 ◽  
Author(s):  
Carrie R. Houts ◽  
James S. McGinley ◽  
R. J. Wirth ◽  
Roger Cady ◽  
Richard B. Lipton
Keyword(s):  
Chronic Migraine ◽  
Discriminant Validity ◽  
Impact Test ◽  
A Priori ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Model Fit ◽  
Sensitivity To Change ◽  
The Impact ◽  
Headache Impact

Abstract Purpose We examined the reliability and validity of the 6-item Headache Impact Test (HIT-6) specifically on patients with chronic migraine (CM) from the PROMISE-2 clinical trial. Methods The conceptual framework of HIT-6 was evaluated using baseline data from the PROMISE-2 study (NCT02974153; N = 1072). A unidimensional graded response model within the item response theory (IRT) framework was used to evaluate model fit and item characteristics. Using baseline and week 12 data, convergent and discriminant validity of the HIT-6 was evaluated by correlation coefficients. Sensitivity to change was assessed by evaluating correlations between HIT-6 scores and change scores for other established reference measures. All examined correlations were specified a priori with respect to direction and magnitude. Known-groups analyses were anchored using Patient Global Impression of Change and monthly headache days at week 12. Results A unidimensional model fit the data well, supporting that the 6 items measure a single construct. All item slopes and thresholds were within acceptable ranges. In both the validity and sensitivity to change analyses, all observed correlations conformed to directional expectations, and most conformed to magnitude expectations. Known-groups analyses demonstrated that the HIT-6 total score can distinguish between clinically meaningful CM subgroups. Conclusion The HIT-6 was successfully calibrated using IRT with data from PROMISE-2. Results from these analyses were generally consistent with previous literature and provided supportive evidence that the HIT-6 is well suited for measuring the impact of headache and migraine in the CM population.

scholarly journals The prevalence and associated factors of undernutrition among under-five children in South Sudan using the standardized monitoring and assessment of relief and transitions (SMART) methodology

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jackline Kiarie ◽  
Sarah Karanja ◽  
Julius Busiri ◽  
Diana Mukami ◽  
Colleta Kiilu
Keyword(s):  
South Sudan ◽  
Child Growth ◽  
World Health ◽  
Large Displacements ◽  
Younger Child ◽  
Growth Standards ◽  
Under Five ◽  
Z Scores ◽  
Health Organization ◽  
Child Age

Abstract Background Conflict regions bear the heaviest brunt of food insecurity and undernutrition. South Sudan is one of the fragile countries following years of conflict that led to large displacements. Moderate to severe undernutrition among under-five children has been associated with elevated morbidity and mortality. This study, therefore, was conducted to assess the magnitude and factors influencing undernutrition (wasting, underweight and stunting) among children aged 6 to 59 months in Yambio County, South Sudan. Methods A cross-sectional study was conducted from 26 October to 6 November 2018 in Yambio County, South Sudan among 630 children aged 6–59 months from the 348 households surveyed in 39 clusters using two-stage cluster sampling design. Data were collected using questionnaires and nutritional anthropometric measurements. The Standardized Monitoring and Assessment of Relief and Transitions (SMART) Methodology was followed to obtain the prevalence of wasting, underweight and stunting based on respective z scores and according to the 2006 world health organization child growth standards. Data were exported to Stata version 16 for further analysis. Bivariate analysis of independent variables and undernutrition was done using binary logistic regression. Mixed effects logistic regression analysis was conducted to control for possible confounders and account for random effects at household and cluster levels. Unadjusted and adjusted odds ratios (cOR and aOR) with 95% confidence intervals (CI) and p-values were computed. P-values of ≤0.05 were considered statistically significant. Results The prevalence of undernutrition explained by wasting (weight-for-height Z-score (WHZ) < − 2), underweight (weight-for-age z-scores (WAZ) < − 2) and stunting (height-for-age z-scores (WHZ) < − 2) were 2.3% (1.3–4.1, 95% CI), 4.8% (3.1–7.5, 95% CI) and 23.8% (19.1–29.2, 95% CI). Male sex (aOR [95% CI], p-value: 5.6 [1.10–30.04], p = 0.038), older child’s age (aOR [95% CI], p-value: 30.4 [2.65–347.60], p = 0.006) and non-residents (cOR [95% CI], p-value: 4.2 [1.4–12.2] p = 0.009) were associated with increased risk of wasting. Household size (cOR [95% CI], p-value: 1.09 [1.01–1.18] p = 0.029) and younger child age (cOR [95% CI], p-value: 4.2 [1.34–13.23] p = 0.014) were significantly associated with underweight. Younger child age (aOR [95% CI], p-value: 5.4 [1.82–16.44] p = 0.003) and agricultural livelihood (aOR [95% CI], p-value: 3.4 [1.61–7.02] p = 0.001) were associated with stunting. Conclusion Based on a cut off of less than − 2 standard deviations for 2006 World Health Organization (WHO) child growth standards, the wasting prevalence was very low, underweight prevalence was low while stunting prevalence was high. The county lies in the only livelihood region in South Sudan with bimodal reliable rainfall pattern and it seems that the impact of the 2016 conflicts that lead to large displacements may not have greatly affected under-five undernutrition. Interventions targeted at improving food diversity, increasing nutrition knowledge and enhancing resilience in male children might reduce undernutrition. In the short-term, investment in continued surveillance of nutritional status should be a main focus.

scholarly journals Hubungan pengetahuan, sikap, perilaku dan karakteristik ibu tentang ASI eksklusif terhadap status gizi bayi

2019 ◽  
Vol 4 (1) ◽  
pp. 28
Author(s):  
Seni Rahayu ◽  
Henni Djuhaeni ◽  
Gaga Irawan Nugraha ◽  
Gurid Eko Mulyo
Keyword(s):  
Nutritional Status ◽  
Exclusive Breastfeeding ◽  
Random Sampling ◽  
Data Retrieval ◽  
Simple Random Sampling ◽  
Child Growth ◽  
Formula Milk ◽  
Growth Standards ◽  
The Impact ◽  
The Relationship

Exclusive breastfeeding is very beneficial for babies. The impact is not given exclusive breastfeeding could be increased morbidity and mortality, nutritional problems, impaired child growth, loss generation, increase the burden of family and state expenditures for the expenditure of formula milk and much more. The purpose of this study was to analyze the relationship of knowledge, attitudes, behaviors and characteristics of mothers towards exclusive breastfeeding with infant nutritional status. This study used a quantitative method with analytic observational design with a case control.. The study was conducted by 110 mothers who had babies aged 6-12 months in the Cibangkong Bandung village. It was consisting of 55 mothers who had babies with nutritional problems and 55 mothers who had babies with normal nutritional status. Data retrieval used a questionnaire. Assessment of nutritional status used the standard WHO child growth standards. The sample was taken by simple random sampling technique. Data analysis using logistic regression test. The results of the analysis showed that there was a relationship between knowledge (p= 0,006), and exclusive breastfeeding behavior (p= 0,013) with the nutritional status of the baby. In addition, maternal characteristics had an effect  of 4,3 times to age and parity in the nutritional status of infants. By knowing the relationship between knowledge factors, attitudes, behaviors and characteristics of mothers with infant nutritional status, it is expected to have leverage to improve the nutritional status of infants. ASI eksklusif sangat bermanfaat bagi bayi, dampak yang dapat terjadi apabila bayi tidak diberikan ASI eksklusif adalah meningkatnya angka kesakitan dan kematian bayi, masalah gizi, gangguan tumbuh kembang anak, terjadinya loss generation, meningkatkan beban pengeluaran keluarga serta negara untuk  pengeluaran susu formula dan masih banyak lagi.  Tujuan penelitian untuk menganalisis hubungan pengetahuan, sikap, perilaku dan karakteristik Ibu terhadap pemberian ASI eksklusif dengan status gizi bayi. Penelitian menggunakan metode kuantitatif dengan desain observasional secara kasus kontrol. Penelitian dilakukan 110  ibu yang memiliki bayi usia 6-12 bulan di kelurahan Cibangkong Bandung yang terdiri dari 55 ibu yang memiliki bayi dengan masalah gizi dan 55 ibu yang memiliki bayi dengan status gizi normal.  Pengambilan data menggunakan kuesioner. Penilaian status gizi menggunakan standar WHO child growth standards. Sampel diambil dengan teknik simple random sampling. Analisis data menggunakan Uji Regresi logistik. Hasil menunjukkan bahwa terdapat hubungan antara pengetahuan (p= 0,006), dan  perilaku pemberian ASI eksklusif (p=0,013) dengan status gizi bayi.  Selain itu, karakteristik ibu yaitu umur dan paritas berpengaruh sebesar 4,3 kali dalam status gizi bayi. Dengan diketahuinya hubungan faktor pegetahuan, sikap, perilaku dan karakteristik ibu dengan status gizi bayi, diharapkan mempunyai daya ungkit terhadap peningkatan status gizi bayi.

scholarly journals WHO child growth standards for Pygmies: one size fits all?

2019 ◽  
Author(s):  
Stephan M. Funk ◽  
Belén Palomo Guerra ◽  
Amy Ickowitz ◽  
Nicias Afoumpam Poni ◽  
Mohamadou Aminou Abdou ◽  
...  
Keyword(s):  
Growth Dynamics ◽  
Severe Anaemia ◽  
Child Growth ◽  
Sub Saharan Africa ◽  
Severe Malnutrition ◽  
Sympatric Populations ◽  
Growth Standards ◽  
Child Undernutrition ◽  
Sub Saharan ◽  
The Impact

AbstractBackgroundAfrican Pygmies exhibit a unique, genetically determined child growth dynamics and adult stature but the impact on assessing undernutrition remains unknown. Baka Pygmy health is highly compromised compared to sympatric populations. Evaluating child undernutrition is an important step to address this health quandry. We estimate stunting and wasting in Cameroon’s Baka children and investigate the applicability of the standards for Pygmy people.MethodsAnthropometric and health data from 685 2-to12 year old children were collected at 25 health centres in southern Cameroon. Growth was analysed using both, WHO Child Growth Standards and the population itself as reference to define frequencies of stunting, wasting and obesity.FindingsBaka children revealed with 68.4% the highest recorded level globally of stunting relative to the WHO child growth standard in 2-to-4 year olds. Wasting was at 8.2% in the upper third range in Sub-Saharan Africa. Obesity was with 6.5% similar to wasting, but no comparable data have been published for Sub-Saharan Africa. When referenced to the Baka population itself, values for stunting were dramatically lower at 1.0% and 2.9% for 2-to-4 and 5-to-12 year olds, respectively. Wasting was also lower at 2.8% and 1.8% and was exceeded by obesity at 3.4% and 3.5%, respectively. Brachial perimeters and oedemas indicated rare severe malnutrition (< 2%) whilst moderate and severe anaemia were frequent (26.6% and 3.3%, respectively).InterpretationWHO child growth standards for stunting are clearly not applicable to Pygmies thus contradicting the widespread emphasis of their ethnicity-independent applicability. The inferred values for wasting and obesity are also difficult to interpret and are likely overestimated by the WHO criteria. To achieve UN Sustainable Development Goals and to fulfil our humanitarian responsibility for fellow man, we recommend that Pygmy specific growth standards are developed for the genetically differing Pygmy tribes.

Impact of Context Information on Metaphor Elaboration

2018 ◽  
Vol 65 (6) ◽  
pp. 370-384 ◽  
Author(s):  
Veronika Lerche ◽  
Ursula Christmann ◽  
Andreas Voss
Keyword(s):  
Diffusion Model ◽  
Processing Speed ◽  
A Priori ◽  
Model Fit ◽  
Verbal Task ◽  
Context Information ◽  
Speed Of Processing ◽  
Good Account ◽  
Dependent Variables ◽  
Decision Settings

Abstract. In experiments by Gibbs, Kushner, and Mills (1991) , sentences were supposedly either authored by poets or by a computer. Gibbs et al. (1991) concluded from their results that the assumed source of the text influences speed of processing, with a higher speed for metaphorical sentences in the Poet condition. However, the dependent variables used (e.g., mean RTs) do not allow clear conclusions regarding processing speed. It is also possible that participants had prior biases before the presentation of the stimuli. We conducted a conceptual replication and applied the diffusion model ( Ratcliff, 1978 ) to disentangle a possible effect on processing speed from a prior bias. Our results are in accordance with the interpretation by Gibbs et al. (1991) : The context information affected processing speed, not a priori decision settings. Additionally, analyses of model fit revealed that the diffusion model provided a good account of the data of this complex verbal task.

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