Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries

Abstract

Background Low- and middle-income countries continue to experience a large burden of stunting; 148 million children were estimated to be stunted, around 30–40% of all children in 2011. In many of these countries, foetal growth restriction (FGR) is common, as is subsequent growth faltering in the first 2 years. Although there is agreement that stunting involves both prenatal and postnatal growth failure, the extent to which FGR contributes to stunting and other indicators of nutritional status is uncertain. Methods Using extant longitudinal birth cohorts (n = 19) with data on birth-weight, gestational age and child anthropometry (12–60 months), we estimated study-specific and pooled risk estimates of stunting, wasting and underweight by small-for-gestational age (SGA) and preterm birth. Results We grouped children according to four combinations of SGA and gestational age: adequate size-for-gestational age (AGA) and preterm; SGA and term; SGA and preterm; and AGA and term (the reference group). Relative to AGA and term, the OR (95% confidence interval) for stunting associated with AGA and preterm, SGA and term, and SGA and preterm was 1.93 (1.71, 2.18), 2.43 (2.22, 2.66) and 4.51 (3.42, 5.93), respectively. A similar magnitude of risk was also observed for wasting and underweight. Low birthweight was associated with 2.5–3.5-fold higher odds of wasting, stunting and underweight. The population attributable risk for overall SGA for outcomes of childhood stunting and wasting was 20% and 30%, respectively. Conclusions This analysis estimates that childhood undernutrition may have its origins in the foetal period, suggesting a need to intervene early, ideally during pregnancy, with interventions known to reduce FGR and preterm birth.

Underweight and Obesity in Low Birth Weight Children in Early Infancy in Japan

“…The prevalence of underweight was significantly higher at Age 5 in both sexes, and the multiple regression analysis indicated that SGA at birth was only associated with underweight in 5-year-old children. Indeed, a review of childhood undernutrition risk based on SGA and preterm birth found that SGA, irrespective of gestational age, was risk factor for underweight at 12 -60 months compared with AGA or term births [34].…”

Prevalence of low weight and small for gestational age in Argentina: Comparison between the INTERGROWTH-21st standard and an Argentine reference

“…SGA is an indicator of intrauterine growth restriction and, together with prematurity, constitutes a risk factor for fetal, neonatal, and infant mortality, and negative consequences on health in the long term. 3,4 There is no international consensus on anthropometric analysis among preterm newborns. The National C o m m i t t e e o n G r o w t h a n d Development (Comité Nacional de Crecimiento y Desarrollo) and the Fetoneonatal Study Committee (Comité de Estudios Fetoneonatales) have proposed the curves obtained by Fenton and Kim for preterm newborn infants (NBIs) follow-up.…”

Path Analysis on Gestational Socio-economic Determinants of Nutritional Status in Children Under Five in Purworejo Regency, Central Java

“…Long-term undernutrition among pregnant mothers is associated with uterus volume and it is a predictor for fetus growth and birth size (low birth weight and length) (Christian et al, 2013).…”