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

作者：Parul Christian, Sun Eun Lee, Moira Donahue Angel, Linda S. Adair, Shams El Arifeen, Per Ashorn, Fernando C. Barros, Caroline Fall, Wafaie Fawzi, Wei Hao, Gang Hu, Jean H. Humphrey, Lieven Huybregts, Charu V Joglekar, Simon Kariuki, Patrick Kolsteren, Ghattu V. Krishnaveni, Enqing Liu, Reynaldo Martorell, David Osrin, Lars Åke Persson, Usha Ramakrishnan, Linda Richter, Dominique Roberfroid, Ayesha Sania, Feiko O. ter Kuile, James M. Tielsch, César G. Victora, Chittaranjan S. Yajnik, Hong Yan, Lingxia Zeng, Robert E. Black · 发表于：International Journal of Epidemiology · 年份：2013 · DOI：10.1093/ije/dyt109 · 被引用次数：611 · 研究领域：Child Nutrition and Water Access、Birth, Development, and Health、Global Maternal and Child Health

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 birthweight, 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 2...