Nutritional Status and Linear Growth of Indonesian Infants in West Java Are Determined More by Prenatal Environment than by Postnatal Factors

Abstract

One of the health problems in Indonesia is the high prevalence of stunting in infants. Determinants and specifically the relative contribution of prenatal and postnatal factors to growth and nutritional status of Indonesian infants were investigated. Newborn infants, from women recruited at approximately 18 wk of pregnancy from 9 rural villages in West Java, Indonesia, were followed until 12-15 mo of age. Weight, length, morbidity, breast-feeding and food intake were assessed monthly. Determinants of length and weight increase and nutritional status reflected by Z-scores were evaluated using multiple linear regression. Neonatal weight (3.2 +/- 0.5 kg) and length (49.7 +/- 2.2 cm) were reasonable. However, growth started to falter at 6-7 mo of age, resulting in prevalences of 24% stunting and 32% underweight at 12 mo of age. The multiple regression models explained 19-41% of the variation in growth and nutritional status of infants. Neonatal weight (beta = 0.285) and length (beta = 0.492) were the strongest positive predictors of weight-for-age and height-for-age Z-scores, respectively. Fever was negatively associated with weight increase (beta = -0.144) and weight-for-age (beta = -0.142) and weight-for-height Z-scores (beta = -0.255) but not with length increase or height-for-age Z-scores. Intake of complementary foods was positively associated with increases in weight (beta = 0.190) and length (beta = 0.179) and nutritional status of infants (beta = 0.136-0.194). In conclusion, in this rural population in West Java, neonatal weight and especially length, reflecting the prenatal environment, are the most important predictors of infant nutritional status.

Stunting at birth: recognition of early-life linear growth failure in the western highlands of Guatemala

“…Nevertheless, we have identified studies, both from Guatemala and in the international literature, with which to compare the present findings. Birth length is often part of protocols in long-term cohort studies bridging from birth through childhood and towards adulthood (40)(41)(42)(43)(44)(45) or short-term, longitudinal observational studies seeking to find correlates of early growth or health (46)(47)(48)(49)(50)(51)(52)(53) . More recently, length is measured at birth as part of studies evaluating inter-pregnancy interventions in (4) .…”

Crescimento de nascidos a termo com peso baixo e adequado nos dois primeiros anos de vida

“…Outros autores também observaram aceleração compensatória do crescimento, especialmente nos seis primeiros meses de vida de crianças com baixo peso, porém, a maioria delas permanece menor e mais magra do que as crianças com peso adequado, mantendo um crescimento paralelo entre os dois grupos. 5,6,16 A condição socioeconômica e ambiental explicou a maior parte da variação do peso e do comprimento das crianças aos 12 meses de vida. Todas as crianças envolvidas no estudo pertenciam a famílias de baixa condição socioeconômica, o que pode justificar a redução ocorrida na mesma época nas crianças dos dois grupos estudados.…”

Mothers' Community Participation and Child Health

“…Maternal height captures many aspects of the mother's background that may be related to her children's health, including the health behaviors and inputs to which she was exposed as a child, and, to some extent, genetic predisposition. Birthweight captures the health condition of the child during the pregnancy, which has been shown to have a strong relationship with children's physical development in many settings (e.g., Conley, Strully, and Bennett 2003) including Indonesia (e.g., Schmidt et al 2002). Maternal height is measured in centimeters; children's birthweight is measured in kilograms.…”