Maternal Height and Child Growth Patterns Addo, O. Yaw, PhD; Stein, Aryeh D., PhD; Fall, Caroline H., DM ...
The Journal of pediatrics,
08/2013, Letnik:
163, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Objective To examine associations between maternal height and child growth during 4 developmental periods: intrauterine, birth to age 2 years, age 2 years to mid-childhood (MC), and MC to adulthood. ...Study design Pooled analysis of maternal height and offspring growth using 7630 mother–child pairs from 5 birth cohorts (Brazil, Guatemala, India, the Philippines, and South Africa). We used conditional height measures that control for collinearity in height across periods. We estimated associations between maternal height and offspring growth using multivariate regression models adjusted for household income, child sex, birth order, and study site. Results Maternal height was associated with birth weight and with both height and conditional height at each age examined. The strongest associations with conditional heights were for adulthood and 2 years of age. A 1-cm increase in maternal height predicted a 0.024 (95% CI: 0.021-0.028) SD increase in offspring birth weight, a 0.037 (95% CI: 0.033-0.040) SD increase in conditional height at 2 years, a 0.025 (95% CI: 0.021-0.029 SD increase in conditional height in MC, and a 0.044 (95% CI: 0.040-0.048) SD increase in conditional height in adulthood. Short mothers (<150.1 cm) were more likely to have a child who was stunted at 2 years (prevalence ratio = 3.20 (95% CI: 2.80-3.60) and as an adult (prevalence ratio = 4.74, (95% CI: 4.13-5.44). There was no evidence of heterogeneity by site or sex. Conclusion Maternal height influences offspring linear growth over the growing period. These influences likely include genetic and non-genetic factors, including nutrition-related intergenerational influences on growth that prevent the attainment of genetic height potential in low- and middle-income countries.
Summary Background Fast weight gain and linear growth in children in low-income and middle-income countries are associated with enhanced survival and improved cognitive development, but might ...increase risk of obesity and related adult cardiometabolic diseases. We investigated how linear growth and relative weight gain during infancy and childhood are related to health and human capital outcomes in young adults. Methods We used data from five prospective birth cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa. We investigated body-mass index, systolic and diastolic blood pressure, plasma glucose concentration, height, years of attained schooling, and related categorical indicators of adverse outcomes in young adults. With linear and logistic regression models, we assessed how these outcomes relate to birthweight and to statistically independent measures representing linear growth and weight gain independent of linear growth (relative weight gain) in three age periods: 0–2 years, 2 years to mid-childhood, and mid-childhood to adulthood. Findings We obtained data for 8362 participants who had at least one adult outcome of interest. A higher birthweight was consistently associated with an adult body-mass index of greater than 25 kg/m2 (odds ratio 1·28, 95% CI 1·21–1·35) and a reduced likelihood of short adult stature (0·49, 0·44–0·54) and of not completing secondary school (0·82, 0·78–0·87). Faster linear growth was strongly associated with a reduced risk of short adult stature (age 2 years: 0·23, 0·20–0·52; mid-childhood: 0·39, 0·36–0·43) and of not completing secondary school (age 2 years: 0·74, 0·67–0·78; mid-childhood: 0·87, 0·83–0·92), but did raise the likelihood of overweight (age 2 years: 1·24, 1·17–1·31; mid-childhood: 1·12, 1·06–1·18) and elevated blood pressure (age 2 years: 1·12, 1·06–1·19; mid-childhood: 1·07, 1·01–1·13). Faster relative weight gain was associated with an increased risk of adult overweight (age 2 years: 1·51, 1·43–1·60; mid-childhood: 1·76, 1·69–1·91) and elevated blood pressure (age 2 years: 1·07, 1·01–1·13; mid-childhood: 1·22, 1·15–1·30). Linear growth and relative weight gain were not associated with dysglycaemia, but a higher birthweight was associated with decreased risk of the disorder (0·89, 0·81–0·98). Interpretation Interventions in countries of low and middle income to increase birthweight and linear growth during the first 2 years of life are likely to result in substantial gains in height and schooling and give some protection from adult chronic disease risk factors, with few adverse trade-offs. Funding Wellcome Trust and Bill & Melinda Gates Foundation.
AbstractObjectiveObesity and noncommunicable disease are rapidly increasing in sub-Saharan Africa. Prevention efforts are critical, particularly for women before conception to maximize ...intergenerational effects. The authors sought to examine perceptions of health and everyday factors that influenced nutrition, exercise, and other health behaviors to inform a novel community preconception intervention. DesignFour focus groups, each with 6–10 participants, were conducted using semistructured interview guides. SettingUrban Soweto, South Africa. ParticipantsYoung nulliparous women aged 18–24 years were recruited using snowball sampling. Phenomenon of InterestHealth behaviors of young women and barriers and facilitators to these behaviors. AnalysisAfter inductive thematic analysis, data were further interpreted within the theoretical framework of the Behavior Change Wheel. ResultsThe data suggested an obesogenic environment in which structural and social factors strongly influenced young women's health choices and limited their capacity for behavior change. Conclusions and ImplicationsCommunity interventions to improve young women's diet, physical activity, and health should recognize (1) the home and social contexts as a source of both role models and barriers to change, (2) the current normalization of obesity, and (3) contextual issues of safety and violence within the community. Understanding young women who overcome these barriers could be beneficial.
Summary Background Both young and advanced maternal age is associated with adverse birth and child outcomes. Few studies have examined these associations in low-income and middle-income countries ...(LMICs) and none have studied adult outcomes in the offspring. We aimed to examine both child and adult outcomes in five LMICs. Methods In this prospective study, we pooled data from COHORTS (Consortium for Health Orientated Research in Transitioning Societies)—a collaboration of five birth cohorts from LMICs (Brazil, Guatemala, India, the Philippines, and South Africa), in which mothers were recruited before or during pregnancy, and the children followed up to adulthood. We examined associations between maternal age and offspring birthweight, gestational age at birth, height-for-age and weight-for-height Z scores in childhood, attained schooling, and adult height, body composition (body-mass index, waist circumference, fat, and lean mass), and cardiometabolic risk factors (blood pressure and fasting plasma glucose concentration), along with binary variables derived from these. Analyses were unadjusted and adjusted for maternal socioeconomic status, height and parity, and breastfeeding duration. Findings We obtained data for 22 188 mothers from the five cohorts, enrolment into which took place at various times between 1969 and 1989. Data for maternal age and at least one outcome were available for 19 403 offspring (87%). In unadjusted analyses, younger (≤19 years) and older (≥35 years) maternal age were associated with lower birthweight, gestational age, child nutritional status, and schooling. After adjustment, associations with younger maternal age remained for low birthweight (odds ratio OR 1·18 (95% CI 1·02–1·36), preterm birth (1·26 1·03–1·53), 2-year stunting (1·46 1·25–1·70), and failure to complete secondary schooling (1·38 1·18–1·62) compared with mothers aged 20–24 years. After adjustment, older maternal age remained associated with increased risk of preterm birth (OR 1·33 95% CI 1·05–1·67), but children of older mothers had less 2-year stunting (0·64 0·54–0·77) and failure to complete secondary schooling (0·59 0·48–0·71) than did those with mothers aged 20–24 years. Offspring of both younger and older mothers had higher adult fasting glucose concentrations (roughly 0·05 mmol/L). Interpretation Children of young mothers in LMICs are disadvantaged at birth and in childhood nutrition and schooling. Efforts to prevent early childbearing should be strengthened. After adjustment for confounders, children of older mothers have advantages in nutritional status and schooling. Extremes of maternal age could be associated with disturbed offspring glucose metabolism. Funding Wellcome Trust and the Bill & Melinda Gates Foundation.
In high-income countries, maternal postnatal depression is associated with adverse outcomes in the child. However, few studies have investigated this relation in countries of low and middle income. ...Furthermore, to our knowledge, no studies have followed up cohorts into later childhood. We aimed to investigate whether maternal depression 6 months after birth is associated with psychological difficulties in a socioeconomically disadvantaged South African cohort of children at age 10 years.
Birth to Twenty is a prospective, longitudinal, birth-cohort study based in the Soweto area of Johannesburg, South Africa. Mothers and children in this cohort have been followed up at timepoints ranging from before birth to age 10 years. Maternal mood was measured at 6 months with the Pitt depression inventory and at 10 years with the Centre for Epidemiologic Studies depression scale (CES-D). Child psychological functioning was assessed at 10 years with the South African child assessment schedule (SACAS). Our primary outcome was psychological development of children at age 10 years, measured by total score on the SACAS. Secondary outcomes were scores on externalising and internalising subscales of the SACAS. We used t tests to compare psychological outcomes between children whose mother had postnatal depression at 6 months and those whose mother did not have postnatal depression. We examined associations between maternal postnatal depression and child psychological outcomes by multivariate linear-regression analysis, adjusting for socioeconomic status and maternal depression at 10 years, and we used logistic regression to provide odds ratios for associations identified by linear regression.
1866 mothers completed the Pitt depression inventory 6 months after the birth of their child; of these, 453 (24%) had symptoms of postnatal depression. At the 10-year assessment, 1012 mothers completed the CES-D questionnaire, of whom 747 (74%) were judged to have depression. Sociodemographic characteristics did not differ between mothers with and without depression at both 6 months and 10 years. After adjusting for socioeconomic status and maternal depression at 10 years, children whose mothers had postnatal depression at 6 months were more than twice as likely to have significant psychological difficulties 10 years later compared with children whose mothers did not have postnatal depression at 6 months (adjusted odds ratio 2·26, 95% CI 1·23–4·16).
Maternal postnatal depression is associated with adverse psychological outcomes in children up to 10 years later in countries of low and middle income. In view of the increased prevalence of postnatal depression in these settings, this finding has important implications for policy and interventions for children and their mothers.
Wellcome Trust (UK), Medical Research Council of South Africa, Human Science Research Council (South Africa), University of the Witwatersrand.
Objective: Findings from a number of cohort studies suggest that children who are exposed to maternal stress during pregnancy have an increased risk of behavioral problems. All of the research ...assessing this association to date has been conducted in developed countries; yet the majority of the child population, and the majority of the burden of psychopathology, exist in developing nations, where different patterns and levels of stressors may exist. The present study set out to examine whether maternal prenatal stress is associated with an increased risk of subsequent child behavioral problems in a developing country. Method: Participants (n = 953) were from Birth to Twenty, a longitudinal birth cohort study based in Soweto-Johannesburg, South Africa, a socioeconomically disadvantaged urban area. Pregnant women completed questionnaires assessing stressors, and children's behavioral functioning was subsequently assessed when they were aged 2 and 4 years. Results: Children whose mothers had high levels of prenatal stressors did not have an increased risk of behavioral problems at age 2 years, but they did at 4 years (adjusted odds ratio 2.52 CI = 1.04, 6.09). Partner conflict and family adversity were the stressors most strongly associated with adverse child outcome. Conclusions: These findings highlight the importance of the psychological health of pregnant women in developing countries, both for the mother and her offspring, and the need for greater research in resource-poor settings. (Contains 4 tables.)
Objective To test the hypothesis that rapid infant weight gain is associated with advanced skeletal maturity in children from the United States and South Africa. Study design Longitudinal data from ...467 appropriate-for-gestational-age infants in the Fels Longitudinal Growth Study (Dayton, Ohio) and 196 appropriate-for-gestational-age infants in the Birth to Twenty birth cohort study (Johannesburg, South Africa) were used. Multiple linear regression models tested the association between internal SD score change in weight from 0 to 2 years and relative skeletal age at 9 years, adjusting for body mass index, stature, and other covariates. Results In both studies, faster infant weight gain was associated with more advanced skeletal maturity (approximately 0.2 years or 2.4 months per SD score) at age 9 years ( P <.0001-.005), even when adjusting for the positive associations of both birth weight and body mass index at age 9 years. This effect appeared to be accounted for by the greater childhood stature of subjects with more rapid infant weight gain. Conclusions Relatively rapid infant weight-gain is associated with advanced skeletal development in late childhood, perhaps via effects on stature.
Rapid epidemiological health transitions occurring in vulnerable populations in Africa that have an existing burden of infectious and non-communicable diseases predict an increased risk and ...consequent prevalence of kidney disease. However, few studies have characterised the true burden of kidney damage and associated risk factors in Africans. We investigated the prevalence of markers for kidney damage and known risk factors in rural and urban settings in sub-Saharan Africa.
In this cross-sectional population study (Africa Wits-International Network for the Demographic Evaluation of Populations and their Health Partnership for Genomic Studies AWI-Gen), we recruited unrelated adult participants aged 40–60 years from four rural community research sites (Nanoro, Burkina Faso; Navrongo, Ghana; Agincourt and Dikgale, South Africa), and two urban community research sites (Nairobi, Kenya; and Soweto, South Africa). Participants were identified and selected using random sampling frames already in use at each site. Participants completed a lifestyle and medical history questionnaire, had anthropometric and blood pressure measurements taken, and blood and urine samples were collected. Markers of kidney damage were defined as low estimated glomerular filtration rate (eGFR; <60 mL/min per 1·73 m2), presence of albuminuria (urine albumin creatinine ratio >3 mg/mmol); or chronic kidney disease (low eGFR or albuminuria, or both). We calculated age-adjusted prevalence of chronic kidney disease, low eGFR, and albuminuria by site and sex and used logistic regression models to assess risk factors of kidney damage.
Between August, 2013, and August, 2016, we recruited 10 702 participants, of whom 8110 were analysable. 4120 (50·8%) of analysable participants were male, with a mean age of 49·9 years (SD 5·8). Age-standardised population prevalence was 2·4% (95% CI 2·1–2·8) for low eGFR, 9·2% (8·4–10·0) for albuminuria, and 10·7% (9·9–11·7) for chronic kidney disease, with higher prevalences in South African sites than in west African sites (14·0% 11·9–16·4 in Agincourt vs 6·6% 5·5–7·9 in Nanoro). Women had a higher prevalence of chronic kidney disease (12·0% 10·8–13·2 vs 9·5% 8·3–10·8) and low eGFR (3·0% 2·6–3·6 vs 1·7% 1·3–2·3) than did men, with no sex-specific differences for albuminuria (9·9% 8·8–11·0 vs 8·4% 7·3–9·7). Risk factors for kidney damage were older age (relative risk 1·04, 95% CI 1·03–1·05; p<0·0001), hypertension (1·97, 1·68–2·30; p<0·0001), diabetes (2·22, 1·76–2·78; p<0·0001), and HIV (1·65, 1·36–1·99; p<0·0001); whereas male sex was protective (0·85, 0·73–0·98; p=0·02).
Regional differences in prevalence and risks of chronic kidney disease in sub-Saharan Africa relate in part to varying stages of sociodemographic and epidemiological health transitions across the area. Public health policy should focus on integrated strategies for screening, prevention, and risk factor management in the broader non-communicable disease and infectious diseases framework.
National Human Genome Research Institute, Office of the Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Environmental Health Sciences, the Office of AIDS Research, and National Institute of Diabetes and Digestive and Kidney Diseases, all of the National Institutes of Health, and the South African Department of Science and Technology.
Prevention of obesity in women of reproductive age is widely recognised to be important both for their health and for that of their offspring. Weight-control interventions, including drug treatment, ...in pregnant women who are obese or overweight have not had sufficient impact on pregnancy and birth outcomes, which suggests that the focus for intervention should include preconception or post-partum periods. Further research is needed into the long-term effects of nutritional and lifestyle interventions before conception. To improve preconception health, an integrated approach, including pregnancy prevention, planning, and preparation is needed, involving more than the primary health-care sector and adopting an ecological approach to risk reduction that addresses personal, societal, and cultural influences. Raising awareness of the importance of good health in the period before pregnancy will require a new social movement: combining bottom-up mobilisation of individuals and communities with a top-down approach from policy initiatives. Interventions to reduce or prevent obesity before conception and during pregnancy could contribute substantially to achievement of the global Sustainable Development Goals, in terms of health, wellbeing, productivity, and equity in current and future generations.
PDF
