scholarly journals Nutritional status of children living within institution-based care: a retrospective analysis with funnel plots and control charts for programme monitoring

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050371
Author(s):  
Emily DeLacey ◽  
Evan Hilberg ◽  
Elizabeth Allen ◽  
Michael Quiring ◽  
Cally J Tann ◽  
...  

ObjectivesThe aim of this study is to fill a key information gap on the nutrition-related epidemiology of orphaned and vulnerable children living within institution-based care (IBC) across six countries.DesignA retrospective analysis with Shewhart control charts and funnel plots to explore intersite and over time variations in nutritional status.SettingWe conducted a retrospective analysis of records from Holt International’s Child Nutrition Programme from 35 sites in six countries; Mongolia, India, Ethiopia, Vietnam, China and the Philippines.ParticipantsDeidentified health records from Holt International’s online nutrition screening database included records from 2926 children, 0–18 years old. Data were collected from 2013 to 2020 and included demographic and health information.ResultsAt initial screening, 717 (28.7%) children were anaemic, 788 (34.1%) underweight, 1048 (37.3%) stunted, 212 (12.6%) wasted, 135 (12%) overweight or obese and 339 (31%) had small head circumference. Many had underlying conditions: low birth weight, 514 (57.5%); prematurity, 294 (42.2%) and disabilities, 739 (25.3%). Children with disabilities had higher prevalence of malnutrition compared with counterparts without disabilities at baseline and 1-year screenings. There was marked intersite variation. Funnel plots highlight sites with malnutrition prevalence outside expected limits for this specific population taking into consideration natural variation at baseline and at 1 year. Control charts show changes in site mean z-scores over time in relation to site control limits.ConclusionsMalnutrition is prevalent among children living within IBC, notably different forms of undernutrition (stunting, underweight, wasting). Underlying risk factors are also common: prematurity, low birth weight and disability. Nutrition interventions should take into account the needs of this vulnerable population, especially for infants and those with disabilities. Using control charts to present data could be especially useful to programme managers as sites outside control limits could represent: problems to be investigated; good practices to be shared.

Neonatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Matthias Fröhlich ◽  
Tatjana Tissen-Diabaté ◽  
Christoph Bührer ◽  
Stephanie Roll

<b><i>Introduction:</i></b> In very low birth weight (&#x3c;1,500 g, VLBW) infants, morbidity and mortality have decreased substantially during the past decades, and both are known to be lower in girls than in boys. In this study, we assessed sex-specific changes over time in length of hospital stay (LOHS) and postmenstrual age at discharge (PAD), in addition to survival in VLBW infants. <b><i>Methods:</i></b> This is a single-center retrospective cohort analysis based on quality assurance data of VLBW infants born from 1978 to 2018. Estimation of sex-specific LOHS over time was based on infants discharged home from neonatal care or deceased. Estimation of sex-specific PAD over time was based on infants discharged home exclusively. Analysis of in-hospital survival was performed for all VLBW infants. <b><i>Results:</i></b> In 4,336 of 4,499 VLBW infants admitted from 1978 to 2018 with complete data (96.4%), survival rates improved between 1978–1982 and 1993–1997 (70.8 vs. 88.3%; hazard ratio (HR) 0.20, 95% confidence interval 0.14, 0.30) and remained stable thereafter. Boys had consistently higher mortality rates than girls (15 vs. 12%, HR 1.23 [1.05, 1.45]). Nonsurviving boys died later compared to nonsurviving girls (adjusted mean survival time 23.0 [18.0, 27.9] vs. 20.7 [15.0, 26.3] days). LOHS and PAD assessed in 3,166 survivors displayed a continuous decrease over time (1978–1982 vs. 2013–2018: LOHS days 82.9 [79.3, 86.5] vs. 60.3 [58.4, 62.1] days); PAD 40.4 (39.9, 40.9) vs. 37.4 [37.1, 37.6] weeks). Girls had shorter LOHS than boys (69.4 [68.0, 70.8] vs. 73.0 [71.6, 74.4] days) and were discharged with lower PAD (38.6 [38.4, 38.8] vs. 39.2 [39.0, 39.4] weeks). <b><i>Discussion/Conclusions:</i></b> LOHS and PAD decreased over the last 40 years, while survival rates improved. Male sex was associated with longer LOHS, higher PAD, and higher mortality rates.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1853
Author(s):  
María A. Reyes-López. ◽  
Carla P. González-Leyva ◽  
Ameyalli M. Rodríguez-Cano ◽  
Carolina Rodríguez-Hernández ◽  
Eloisa Colin-Ramírez ◽  
...  

A high-quality diet during pregnancy may have positive effects on fetal growth and nutritional status at birth, and it may modify the risk of developing chronic diseases later in life. The aim of this study was to evaluate the association between diet quality and newborn nutritional status in a group of pregnant Mexican women. As part of the ongoing Mexican prospective cohort study, OBESO, we studied 226 healthy pregnant women. We adapted the Alternated Healthy Eating Index-2010 for pregnancy (AHEI-10P). The association between maternal diet and newborn nutritional status was investigated by multiple linear regression and logistic regression models. We applied three 24-h recalls during the second half of gestation. As the AHEI-10P score improved by 5 units, the birth weight and length increased (β = 74.8 ± 35.0 g and β = 0.3 ± 0.4 cm, respectively, p < 0.05). Similarly, the risk of low birth weight (LBW) and small for gestational age (SGA) decreased (OR: 0.47, 95%CI: 0.27–0.82 and OR: 0.55, 95%CI: 0.36–0.85, respectively). In women without preeclampsia and/or GDM, the risk of stunting decreased as the diet quality score increased (+5 units) (OR: 0.62, 95%IC: 0.40–0.96). A high-quality diet during pregnancy was associated with a higher newborn size and a reduced risk of LBW and SGA in this group of pregnant Mexican women.


2020 ◽  
Vol 1 (1) ◽  
pp. 16
Author(s):  
Hatijar Hatijar

Low birth weight babies are babies born with a weight less than 2500 grams. LBW (low birth weight) affects the high mortality rate in infants and is at risk of experiencing obstacles in growth and development. LBW is generally caused due to lack of nutrition and nutritional needs from mother to fetus while pregnant women aged less than 20 years and more than 35 years have the risk of giving birth to LBW. The purpose of this study is to determine the risk factors that cause LBW based on maternal age and nutritional status. The research method used was observational with a cross sectional study approach. The sampling technique was random sampling at the Regional Haji Makassar General Hospital in the January to July 2015 period with a total sample of 65 people. Analysis using the Chi Square Test. The results showed that there was a relationship between maternal age, nutritional status of LBW with a value (p value = 0.00 <α = 0.05). Maternal age and nutritional status are factors that influence low birth weight where the results of the study indicate that there is a relationship between maternal age and nutritional status on the incidence of low birth weight. To reduce the incidence of low birth weight, it is necessary to increase counseling about the causes of low birth weight babies by health workers, especially midwives to pregnant women to prevent the risk of low birth weight birth.


PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 916-921 ◽  
Author(s):  
Staffan K. T. Polberger ◽  
Göran A. Fex ◽  
Irene E. Axelsson ◽  
Niels C. R. Räihä

Concentrations of 11 plasma proteins were measured in 28 healthy, growing, very low birth weight, appropriate-for-gestational-age infants fed varying levels of human milk protein intake (range 1.7 to 3.9 g/kg per day). Significant positive correlations were found between ween mean protein intake and concentrations of 7 of the plasma proteins studied (transthyretin, retinol-binding protein, and transferrin: P &lt; .001; vitamin D-binding protein and apolipoprotein B: P &lt; .01; albumin and apolipoprotein A I: P &lt; .05). A weak negative correlation with mean protein intake was seen for the plasma level of orosomucoid, whereas no significant correlations were found for the plasma concentrations of fibronectin and α1-antichymotrypsin. Protein intake, not energy intake, constituted the main contribution to the changes in the concentrations of transthyretin, retinol-binding protein, and transferrin. The levels of plasma transthyretin and transferrin were also strongly correlated with weight and length growth of the infants during the study as well as with other indicators of protein nutritional status such as preprandial concentrations of plasma amino acids and serum and urine urea. These data indicate that of the 11 plasma proteins studied, transthyretin, transferrin, and retinol-binding protein are the most suitable to evaluate protein nutritional status in very low birth weight infants.


2018 ◽  
Vol 24 (8) ◽  
pp. 6203-6205
Author(s):  
Yoga Dwi Oktavianda ◽  
Syahru Ramadhan ◽  
Thalia Mufida ◽  
Ummul Mukminin ◽  
Rima Irwinda

Low birth weight is one of the determinants of infant mortality, morbidity, and disability, which can even have an impact on the future. Several studies have suggested that the condition of low birth weight (LBW) infants is influenced by the lack of maternal nutritional status in early pregnancy. Moreover, the prevalence of malnutrition in Indonesia is still high. Therefore, this study attempted to analyze the relationship of maternal nutritional status in early pregnancy as a predictor of LBW infants. Using a cross-sectional study design, this study involved 62 pregnant patients aged 20–35 years who had antenatal visits and a term delivery at Puskesmas Kecamatan Cakung. The measurements of body mass index (BMI) and mid-upper arm circumference (MUAC) in early pregnancy are used to determine the maternal nutritional status. Pregnant women with BMI <18.5 or MUAC <23.5 cm are considered to have less nutritional status. Meanwhile, LBW infants are defined as babies with birth weight <2500 grams. This study proves that the risk of birth of LBW infants is increased in pregnant women with BMI <18.5 (underweight) (OR 5.37) and less MUAC (OR 20.4).


2011 ◽  
Vol 26 (11) ◽  
pp. 1405-1410 ◽  
Author(s):  
Dae-Hyun Jang ◽  
In Young Sung ◽  
Jae Yong Jeon ◽  
Hye Jin Moon ◽  
Ki-Soo Kim ◽  
...  

The authors reviewed the medical records of very low-birth-weight infants admitted from 1998 to 2007 and compared neurodevelopmental outcomes with their previously reported data from 1989 to 1997. The recent group included 824 infants, and the previous group included 471 infants. Neurodevelopmental outcomes were classified into cerebral palsy and non–cerebral palsy neurodevelopmental impairment. In the recent group, the survival rate was significantly higher (79.4% vs 66.2%), the rate of cerebral palsy was lower (7.9% vs 10.5%), and the rate of non–cerebral palsy neurodevelopmental impairment was higher (6.0% vs 4.5%) but not significant. The survival rate increased significantly over time, but there was no significant change in neurodevelopmental outcomes over time. Multivariate analysis indicated that abnormal neurosonographic findings, using assisted ventilation, vaginal delivery, and abnormal brainstem auditory evoked potential, were associated with increased risk for cerebral palsy.


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