TY - JOUR
T1 - Birth length is the strongest predictor of linear growth status and stunting in the first 2 years of life after a preconception maternal nutrition intervention
T2 - the children of the Women First trial
AU - Krebs, Nancy F.
AU - Hambidge, K. Michael
AU - Westcott, Jamie L.
AU - Garces, Ana L.
AU - Figueroa, Lester
AU - Tshefu, Antoinette K.
AU - Lokangaka, Adrien L.
AU - Goudar, Shivaprasad S.
AU - Dhaded, Sangappa M.
AU - Saleem, Sarah
AU - Ali, Sumera Aziz
AU - Bauserman, Melissa S.
AU - Derman, Richard J.
AU - Goldenberg, Robert L.
AU - Das, Abhik
AU - Chowdhury, Dhuly
AU - Thorsten, Vanessa R.
AU - Sridhar, Amaanti
AU - McClure, Elizabeth
AU - Herekar, Veena
AU - Yogeshkumar, S.
AU - Vernekar, Sunil S.
AU - Somannavar, Manjunath
AU - Bose, Carl L.
AU - Koso-Thomas, Marion
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of the American Society for Nutrition.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Background: The multicountry Women First trial demonstrated that nutritional supplementation initiated prior to conception (arm 1) or early pregnancy (arm 2) and continued until delivery resulted in significantly greater length at birth and 6 mo compared with infants in the control arm (arm 3). Objectives: We evaluated intervention effects on infants' longitudinal growth trajectory from birth through 24 mo and identified predictors of length status and stunting at 24 mo. Methods: Infants' anthropometry was obtained at 6, 12, 18, and 24 mo after the Women First trial (registered at clinicaltrials.gov as NCT01883193), which was conducted in low-resource settings: Democratic Republic of Congo, Guatemala, India, and Pakistan. Longitudinal models evaluated intervention effects on infants' growth trajectory from birth to 24 mo, with additional modeling used to identify adjusted predictors for growth trajectories and outcomes at 24 mo. Results: Data for 2337 (95% of original live births) infants were evaluated. At 24 mo, stunting rates were 62.8%, 64.8%, and 66.3% for arms 1, 2, and 3, respectively (NS). For the length-for-age z-score (LAZ) trajectory, treatment arm was a significant predictor, with adjusted mean differences of 0.19 SD (95% CI: 0.08, 0.30; P < 0.001) and 0.17 SD (95% CI: 0.07, 0.27; P < 0.001) for arms 1 and 2, respectively. The strongest predictors of LAZ at 24 mo were birth LAZ <-2 and <-1 to ≥-2, with adjusted mean differences of -0.76 SD (95% CI: -0.93, -0.58; P < 0.001) and -0.47 SD (95% CI: -0.56, -0.38; P < 0.001), respectively. For infants with ultrasound-determined gestational age (n = 1329), the strongest predictors of stunting were birth LAZ <-2 and <-1 to ≥- 2: adjusted relative risk of 1.62 (95% CI: 1.39, 1.88; P < 0.001) and 1.46 (95% CI: 1.31, 1.62; P < 0.001), respectively. Conclusions: Substantial improvements in postnatal growth are likely to depend on improved intrauterine growth, especially during early pregnancy.
AB - Background: The multicountry Women First trial demonstrated that nutritional supplementation initiated prior to conception (arm 1) or early pregnancy (arm 2) and continued until delivery resulted in significantly greater length at birth and 6 mo compared with infants in the control arm (arm 3). Objectives: We evaluated intervention effects on infants' longitudinal growth trajectory from birth through 24 mo and identified predictors of length status and stunting at 24 mo. Methods: Infants' anthropometry was obtained at 6, 12, 18, and 24 mo after the Women First trial (registered at clinicaltrials.gov as NCT01883193), which was conducted in low-resource settings: Democratic Republic of Congo, Guatemala, India, and Pakistan. Longitudinal models evaluated intervention effects on infants' growth trajectory from birth to 24 mo, with additional modeling used to identify adjusted predictors for growth trajectories and outcomes at 24 mo. Results: Data for 2337 (95% of original live births) infants were evaluated. At 24 mo, stunting rates were 62.8%, 64.8%, and 66.3% for arms 1, 2, and 3, respectively (NS). For the length-for-age z-score (LAZ) trajectory, treatment arm was a significant predictor, with adjusted mean differences of 0.19 SD (95% CI: 0.08, 0.30; P < 0.001) and 0.17 SD (95% CI: 0.07, 0.27; P < 0.001) for arms 1 and 2, respectively. The strongest predictors of LAZ at 24 mo were birth LAZ <-2 and <-1 to ≥-2, with adjusted mean differences of -0.76 SD (95% CI: -0.93, -0.58; P < 0.001) and -0.47 SD (95% CI: -0.56, -0.38; P < 0.001), respectively. For infants with ultrasound-determined gestational age (n = 1329), the strongest predictors of stunting were birth LAZ <-2 and <-1 to ≥- 2: adjusted relative risk of 1.62 (95% CI: 1.39, 1.88; P < 0.001) and 1.46 (95% CI: 1.31, 1.62; P < 0.001), respectively. Conclusions: Substantial improvements in postnatal growth are likely to depend on improved intrauterine growth, especially during early pregnancy.
KW - birth length
KW - breastfeeding
KW - growth
KW - infant growth
KW - maternal height
KW - preconception
KW - stunting
UR - http://www.scopus.com/inward/record.url?scp=85134366046&partnerID=8YFLogxK
U2 - 10.1093/ajcn/nqac051
DO - 10.1093/ajcn/nqac051
M3 - Article
C2 - 35681255
AN - SCOPUS:85134366046
SN - 0002-9165
VL - 116
SP - 86
EP - 96
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 1
ER -