scholarly journals 839A novel approach to investigating poor growth in a longitudinal study of infants in PNG

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Clarissa Moreira ◽  
Michelle Scoullar ◽  
Elizabeth Peach ◽  
Ruth Fidelis ◽  
Pele Melepeia ◽  
...  
Keyword(s):  
Structural Equation ◽  
Maternal Nutrition ◽  
Post Partum ◽  
Quadratic Function ◽  
Infant Growth ◽  
Simultaneous Estimation ◽  
Birth Size ◽  
Maternal Height ◽  
Maternal Factors ◽  
Poor Growth

Abstract Background Children in Papua New Guinea (PNG) experience high rates of malnutrition and poor growth - nearly half of children under 5 are stunted and 16% wasted. Methods We investigated predictors of infant growth over the first year of life using longitudinal data from mothers and infants in PNG. Between 2015 and 2018, 699 pregnant women were enrolled. At delivery, one, 6- and 12-months post-partum blood samples and anthropometric measurements were taken from mothers and infants. Using structural equation modelling with full information maximum likelihood, multivariate latent growth curve (LGC) modelling for infant weight and length (i.e. simultaneous estimation) was undertaken, and maternal factors that influenced growth investigated. Results A quadratic function for growth (weight and height) was estimated. Boys were larger at birth (49cm, 3.2kg vs. 48cm, 3.0kg; Wald χ2(2) =15.3, p<0.001) and gained more weight and length monthly (Wald χ2(4) =68.4, p<0.001). Maternal height, MUAC and number of antenatal healthcare visits were associated with birth weight and length, but not growth. Maternal nutrition and infections, breastfeeding and complementary feeding were not associated with birth size or growth. Conclusions Maternal height and MUAC and antenatal healthcare were associated with birth size and no maternal factors were associated with growth. Prenatal interventions to improve postnatal infant growth may be challenging in this environment Key messages Compared to conventional LGC analysis, multivariate LGC modelling using SEM provides less biased estimates of infant growth and factors associated with growth, particularly in the presence of missing data and infant-specific weight and height heterogeneity.

scholarly journals Influences on catch-up growth using relative versus absolute metrics: evidence from the MAL-ED cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie A. Richard ◽  
Benjamin J. J. McCormick ◽  
Laura E. Murray-Kolb ◽  
Pascal Bessong ◽  
Sanjaya K. Shrestha ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Income ◽  
Cognitive Outcomes ◽  
Absolute Difference ◽  
Maternal Height ◽  
Z Score ◽  
Linear Regression Models ◽  
Poor Growth ◽  
Micronutrient Status

Abstract Background Poor growth in early childhood has been considered irreversible after 2–3 years of age and has been associated with morbidity and mortality over the short-term and with poor economic and cognitive outcomes over the long-term. The MAL-ED cohort study was performed in eight low-income settings with the goal of evaluating relationships between the child’s environment and experience (dietary, illness, and pathogen exposure, among others) and their growth and development. The goal of this analysis is to determine whether there are differences in the factors associated with growth from 24 to 60 months using two different metrics. Methods Across six MAL-ED sites, 942 children had anthropometry data at 24 and 60 months, as well as information about socioeconomic status, maternal height, gut permeability (lactulose-mannitol z-score (LMZ)), dietary intake from 9 to 24 months, and micronutrient status. Anthropometric changes were in height- or weight-for-age z-score (HAZ, WAZ), their absolute difference from the growth standard median (HAD (cm), WAD (kg)), as well as recovery from stunting/underweight. Outcomes were modeled using multivariate regression. Results At 24 months, almost half of the cohort was stunted (45%) and 21% were underweight. Among those who were stunted at 24 months (n = 426), 185 (43%) were no longer stunted at 60 months. Most children increased their HAZ from 24 to 60 months (81%), whereas fewer (33%) had positive changes in their HAD. Linear regression models indicate that girls improved less than boys from 24 to 60 months (HAZ: -0.21 (95% CI -0.27, -0.15); HAD: -0.75 (-1.07, -0.43)). Greater intestinal permeability (higher LMZ) at 0–24 months was associated with lower relative and absolute changes from 24 to 60 months (HAZ: -0.10 (-0.16, -0.04); HAD: -0.47 (-0.73, -0.21)). Maternal height (per 10 cm) was positively associated with changes (HAZ: 0.09 (0.03, 0.15); HAD: 0.45 (0.15, 0.75)). Similar relationships were identified for changes in WAZ and WAD. Conclusions The study children demonstrated improved growth from 24 to 60 months of age, but only a subset had positive changes in HAD and WAD. The same environmental factors were associated with growth from 24 to 60 months regardless of metric used (change in HAZ or HAD, or WAZ and WAD).

scholarly journals Osteopontin Levels in Human Milk Are Related to Maternal Nutrition and Infant Health and Growth

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2670
Author(s):  
Aysegül Aksan ◽  
Izzet Erdal ◽  
Siddika Songül Yalcin ◽  
Jürgen Stein ◽  
Gülhan Samur
Keyword(s):  
Immune System ◽  
Breast Milk ◽  
Infant Health ◽  
Maternal Nutrition ◽  
System Development ◽  
Maternal Factors ◽  
Immune System Development ◽  
The Mean ◽  
Pregnancy Weight

Background: Osteopontin (OPN) is a glycosylated phosphoprotein found in human tissues and body fluids. OPN in breast milk is thought to play a major role in growth and immune system development in early infancy. Here, we investigated maternal factors that may affect concentrations of OPN in breast milk, and the possible associated consequences for the health of neonates. Methods: General characteristics, health status, dietary patterns, and anthropometric measurements of 85 mothers and their babies were recorded antenatally and during postnatal follow-up. Results: The mean concentration of OPN in breast milk was 137.1 ± 56.8 mg/L. Maternal factors including smoking, BMI, birth route, pregnancy weight gain, and energy intake during lactation were associated with OPN levels (p < 0.05). Significant correlations were determined between body weight, length, and head circumference, respectively, and OPN levels after one (r = 0.442, p = < 0.001; r = −0.284, p = < 0.001; r = −0.392, p = < 0.001) and three months (r = 0.501, p = < 0.001; r = −0.450, p = < 0.001; r = −0.498, p = < 0.001) of lactation. A negative relation between fever-related infant hospitalizations from 0–3 months and breast milk OPN levels (r = −0.599, p < 0.001) was identified. Conclusions: OPN concentrations in breast milk differ depending on maternal factors, and these differences can affect the growth and immune system functions of infants. OPN supplementation in infant formula feed may have benefits and should be further investigated.

scholarly journals Exploring the Nutritional Ecology of Stunting: New Approaches to an Old Problem

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 371
Author(s):  
Daniel J. Raiten ◽  
Andrew A. Bremer
Keyword(s):  
Global Health ◽  
Food Insecurity ◽  
Maternal Nutrition ◽  
Nutritional Assessment ◽  
Current Knowledge ◽  
Clinical Care ◽  
Nutritional Ecology ◽  
Physical Growth ◽  
Poor Growth ◽  
Pregnancy And Lactation

Despite a declining prevalence, stunting remains an elusive target for the global health community. The perception is that stunting represents chronic undernutrition (i.e., due to inadequate nutrient intake associated with food insecurity, low-quality diet, and suboptimal infant feeding practices in the first two years of life). However, other causes include maternal–fetal interactions leading to intrauterine growth retardation, poor maternal nutrition during pregnancy and lactation, and maternal and pediatric infections. Moreover, physical, economic, demographic, and social environments are major contributors to both food insecurity and conditions that limit linear growth. Overall, factors representing both the internal and external “nutritional ecologies” need to be considered in efforts to reduce stunting rates. Nutritional assessment requires better understanding of the mechanism and role of nutrition in growth, clear expectations about the sensitivity and specificity of the tools used, and inclusion of bio-indicators reflecting the extent and nature of the functional effect of poor nutrition and environmental factors contributing to human physical growth. We provide a perspective on current knowledge about: (i) the biology and contribution of nutrition to stunting/poor growth; (ii) our current nutritional assessment toolkit; (iii) the implications of current assessment approaches for clinical care and public interventions; and (iv) future directions for addressing these challenges in a changing global health environment.

scholarly journals Associations of maternal nutrition during pregnancy and post‐partum with maternal cognition and caregiving

2017 ◽  
Vol 14 (2) ◽  
Author(s):  
Elizabeth L. Prado ◽  
Ulla Ashorn ◽  
John Phuka ◽  
Kenneth Maleta ◽  
John Sadalaki ◽  
...  
Keyword(s):  
Maternal Nutrition ◽  
Post Partum ◽  
Maternal Cognition

scholarly journals Breast Milk Iodine Concentration Is Associated with Infant Growth, Independent of Maternal Weight

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 358 ◽  
Author(s):  
Lindsay Ellsworth ◽  
Harlan McCaffery ◽  
Emma Harman ◽  
Jillian Abbott ◽  
Brigid Gregg
Keyword(s):  
Breast Milk ◽  
Weight Status ◽  
Post Partum ◽  
Iodine Content ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Infant Growth ◽  
Maternal Weight ◽  
Significant Difference ◽  
Pregnancy Weight

In breastfed infants, human milk provides the primary source of iodine to meet demands during this vulnerable period of growth and development. Iodine is a key micronutrient that plays an essential role in hormone synthesis. Despite the importance of iodine, there is limited understanding of the maternal factors that influence milk iodine content and how milk iodine intake during infancy is related to postnatal growth. We examined breast milk samples from near 2 weeks and 2 months post-partum in a mother-infant dyad cohort of mothers with pre-pregnancy weight status defined by body mass index (BMI). Normal (NW, BMI < 25.0 kg/m2) is compared to overweight/obesity (OW/OB, BMI ≥ 25.0 kg/m2). The milk iodine concentration was determined by inductively coupled plasma mass spectrometry. We evaluated the associations between iodine content at 2 weeks and infant anthropometrics over the first year of life using multivariable linear mixed modeling. Iodine concentrations generally decreased from 2 weeks to 2 months. We observed no significant difference in iodine based on maternal weight. A higher iodine concentration at 2 weeks was associated with a larger increase in infant weight-for-age and weight-for-length Z-score change per month from 2 weeks to 1 year. This pilot study shows that early iodine intake may influence infant growth trajectory independent of maternal pre-pregnancy weight status.

scholarly journals Association Between Prelacteal Feeding and Infant Growth

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 917-917
Author(s):  
Hanzhi Tong ◽  
Andrew Thorne-Lyman ◽  
Amanda Palmer ◽  
Saijuddin Shaikh ◽  
Hasmot Ali ◽  
...  
Keyword(s):  
Maternal Education ◽  
Low Birthweight ◽  
Post Partum ◽  
Potential Effect ◽  
Infant Growth ◽  
Prelacteal Feeding ◽  
Project Staff ◽  
Adjusted Risk ◽  
Funding Sources ◽  
Gates Foundation

Abstract Objectives To assess the association between exposure to prelacteal feeding and infant growth from birth to 3 months of age. Methods We analyzed data from a cohort of mothers and infants (n = 2569) identified as part of ongoing pregnancy and birth surveillance in rural Gaibandha, Bangladesh. Trained interviewers visited women in their households during pregnancy to collect sociodemographic data. Project staff were notified of a birth by telephone and interviewers visited the home within three days post-partum, at one-week, and at three months. At each visit, interviewers collected detailed data on breastfeeding, any foods provided to the infant other than breast milk, and morbidity. Infant weight, length, and mid-upper arm circumference were measured according to standardized protocols at birth and three months of age. For analysis, we defined exposure to prelacteal feeding (PLF) as giving infants any food or liquid other than breastmilk within first 3 days of life. Infant length and weight measurements were used to produce length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) Z-scores. Stunting, wasting, and underweight were defined as a LAZ, WLZ, or WAZ &lt; −2, respectively. We used multiple linear regression and multiple logistic regression to assess the association between anthropometric indices and PLF practices, controlling for low birthweight, infant sex, infant age, maternal education, maternal age, and wealth. Results The prevalence of PLF was 25.2%. The prevalence of stunting, wasting and underweight was 29.0%, 3.8% and 22.3%, respectively. For stunting (adjusted risk ratio (ARR) = 1.02 [95% CI: 0.89–1.16]) and wasting (ARR = 0.97 [95% CI: 0.63–1.50]), there were no differences between infants who received PLF and infants who did not receive any PLF. Infants who received PLF tended to have higher risk of underweight (ARR = 1.10 [95% CI: 0.95–1.28]). For LAZ, WAZ, and WLZ score, no differences were observed in the adjusted analysis between infants who received PLF and those who did not receive any PLF. Conclusions There was no association between exposure to PLF and infant growth from birth to 3 months of age. More research is needed to explore the potential effect of PLF on other outcomes. Funding Sources Bill & Melinda Gates Foundation; Johnson & Johnson; UBS Optimus Foundation.

scholarly journals Why Are Adolescent Mothers More iikely to Have Stunted and Underweight Children Than Adult Mothers? A Path Analysis Using Data from 30,000 Bangladeshi Mothers, 1996–2014

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1463-1463
Author(s):  
Phuong Nguyen ◽  
Samuel Scott ◽  
Long Khuong ◽  
Priyanjana Pramanik ◽  
Akhter Ahmed ◽  
...  
Keyword(s):  
Adolescent Pregnancy ◽  
Adolescent Mothers ◽  
Structural Equation ◽  
Service Use ◽  
Structural Equation Models ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Age At First Birth ◽  
Child Feeding ◽  
Poor Growth

Abstract Objectives Adolescent pregnancy is a major global concern due to its adverse effects on maternal and child health and wellbeing. Bangladesh has one of the highest rates of adolescent pregnancy globally. We sought to examine trends in adolescent pregnancy and associated factors in Bangladesh in the last two decades, and to understand why children of adolescent mothers are at high risk of poor growth. Methods Data were from 6 rounds of Bangladesh Demographic and Health Survey (1996–2014). Women aged 15–49 years who gave birth in the 5 years preceding each survey (n = 30,331) were classified based on age at first birth: ≤19 years (adolescence), 20–24 years (young adulthood), and ≥25 years (adulthood). Trend analysis was used to assess the progress over time. Multivariable regression and structural equation models were used to understand how adolescent pregnancy is linked to child undernutrition through maternal nutritional status, education and bargaining power, health service use, child feeding and living conditions. Results Adolescent pregnancy has declined slowly, from 84% in 1996 to 73% in 2014. Children born to adolescent mothers had lower z-scores for height-for-age (mean difference: −0·64 SD), weight-for-age (−0·45 SD), and higher prevalence of stunting (18 percentage points [pp]) and underweight (12pp) than children born to adult mothers. Compared to adult mothers, adolescent mothers were shorter (−0·8 cm), lighter (−6.9 kg), more likely to be underweight (+14pp), had lower education (−4·3 years), less decision-making power (−9pp), and lived in poorer households (−0·79 SD) with poorer sanitation (−23pp) (all P &lt; 0.05). Adolescent mothers were less likely to access ANC (−20pp), institutional delivery (−42pp), postnatal care services (−24pp) and had poorer complementary feeding practices (−15pp). In path analyses, these intermediate factors explained 66% of the association between adolescent pregnancy and child anthropometry, with the strongest links being through women's weight, education, socioeconomic status and complementary feeding practices. Conclusions Adolescent pregnancy is still the norm in Bangladesh. Policies and programs to address poverty and improve women's education can help to improve women's health, reduce early childbearing and break the intergenerational cycle of poverty and undernutrition. Funding Sources A4NH at IFPRI.

scholarly journals Maternal Characteristics Determine Stunting in Children of Less than Five Years of Age Results from a National Probabilistic Survey

2008 ◽  
Vol 1 ◽  
pp. CMPed.S1019 ◽  
Author(s):  
Teresa Shamah-Levy ◽  
Lucia Cuevas Nasu ◽  
Hortensia Moreno-Macias ◽  
Eric Monterrubio-Flores ◽  
Marco Antonio Avila-Arcos
Keyword(s):  
Social Services ◽  
Maternal Nutrition ◽  
Marginal Effect ◽  
Sociodemographic Characteristics ◽  
Maternal Height ◽  
Nutrition Survey ◽  
Maternal Characteristics ◽  
Children Under Five ◽  
Under Five ◽  
Mother And Child

Background Maternal nutrition and some variables are the main determining factors of birthweight and delayed intrauterine growth of children. Objective To explore the association between the mothers’ biological and sociodemographic characteristics, and the anthropometry status in children under five years of age. Design The population consisted of a sub-sample of 1,047 mother-and-child selected pairs from the probabilistic National Nutrition Survey, carried out in Mexico. Mother-and-child pairs included mothers aged 12 to 49 years, with children under five years of age. Data on sociodemographic characteristics, obstetric history, 24-hour recall dietary intake, and the women and children's anthropometry were collected. The association between maternal characteristics and children's anthropometry status was assessed using multiple logistic regression models. Result Nearly 16.7% of the children <5y of age were stunted (13.5% ≤ 2y and 18.8% > 2y). The height/age of the children was severely affected by maternal height and birth order. In addition, the interaction between socioeconomic level and maternal schooling had a marginal effect (p = 0.09) in the ≤2y group. On the other hand, whether the family received social services and the interaction between maternal height and a dichotomy urbanism variable were significant (p = 0.05) and (p < 0.01) respectively in >2y group. Conclusion Some biological and socioeconomic characteristics among mothers have a negative effect on their children's attained size, especially in the period between 2 and 5 years of age.

scholarly journals Beberapa Faktor yang Berpengaruh terhadap Pencegahan Puerperium Infections

2019 ◽  
Vol 8 (01) ◽  
pp. 8-21
Author(s):  
Magdalena Agu Yosali ◽  
Retno Sugesti
Keyword(s):  
Structural Equation Model ◽  
Structural Equation ◽  
Post Partum ◽  
Equation Model ◽  
Personal Hygiene

Infeksi nifas bisa berasal dari luka pada jalan  lahir  yang  merupakan  media  yang  baik  untuk  berkembangnya kuman. Penanganan komplikasiyang lambat dapat menyebabkan terjadinya kematian ibu post partum. Tujuan penelitian ini adalah mengetahui pengaruh langsung dan tidak langsung serta besarannya sumber informasi, peran nakes, peran kader, peran keluarga dan personal hygiene perception terhadap pencegahan puerperium infections pada ibu nifas di UPTD Puskesmas Kecamatan Pontianak Selatan Kalimantan Barat tahun 2018. Metode yang digunakan dalam penelitian ini adalah pendekatan kuantitatif yang menggunakan desain cross-setional (potong lintang). Sampel yang digunakan sebanyak 60 kliensebagai responden. Metode analisis yang digunakan adalah Structural Equation Model (SEM). Hasil pengujian hipotesis menghasilkan temuan penelitian yaitu variabel pencegahan puerperium infections dipengaruhi oleh sumber informasi (7,31%), peran tenaga kesehatan (23,02%), peran kader (19,26%), peran keluarga (18,77%), personal hygiene Perception (13,08%). Peran tenaga kesehatan merupakan faktor yang dominan yang sangat mempengaruhi pencegahan puerperium infections di UPTD Puskesmas Kecamatan Pontianak Selatan. Pengaruh langsung pencegahanpuerperium infections sebesar 81,44%,  pengaruh tidak langsung sebesar 1,89% dan pengaruh total langsung dan tidak langsung sebesar 83,34%.Diharapkan adanya peran dari petugas kesehatan dalam memberikan pemahaman mengenai pencegahan infeksi nifas dan memberikan bimbingan kepada kader wilayah kerja mengenai pencegahan infeksi nifas.

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