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Fetal growth, early postnatal growth and motor development in Pakistani infants
Y B Cheung1, P S Yip, J P Karlberg
1Department of Paediatrics, Clinical Trials Centre, Faculty of Medicine, University of Hong Kong, PR China.
Insights
Infant motor development is affected by both birth size and early growth. Both thinness at birth and postnatal growth issues were linked to delayed gross and fine motor skills in babies.
Area of Science:
- Pediatric research
- Developmental pediatrics
- Infant growth and development
Background:
- Limited research exists on the association between a wide range of birth sizes and infant motor development.
- The impact of early postnatal growth on motor development is understudied.
- Distinguishing between shortness and thinness in growth failure requires further investigation.
Purpose of the Study:
- To investigate the association between birth size (length and thinness) and early postnatal growth with motor development in infants.
- To differentiate the effects of stunting and wasting on motor skill acquisition.
- To explore the influence of a broad spectrum of anthropometric indicators on infant motor milestones.
Main Methods:
- Longitudinal study of infants born in Lahore, Pakistan (1984-1987).
- Assessed gross motor development (age at independent walking) and fine motor development (age at building a 3-cube tower).
- Analyzed birth size (length, thinness) and postnatal growth (changes in length and thinness from birth to 6 months) using generalized log gamma regression.
Main Results:
- Thinness at birth, postnatal stunting, and wasting were inversely associated with gross motor development (P < 0.05).
- Birth length showed a non-linear inverse association with gross motor development (P < 0.05).
- Birth length, birth thinness, and postnatal wasting were inversely associated with fine motor development (P < 0.05).
Conclusions:
- Both fetal and early postnatal growth, across a wide range, can impact infant motor development.
- Motor development issues are not limited to infants who are small at birth.
- Birth length appears to be a more significant factor in motor development than other anthropometric measures.
Background:
Studies have often compared the postnatal motor development of 'small' versus 'normal' newborns. Not much is known about the associations between a broad spectrum of size at birth and motor development. The effect of early postnatal growth on motor development is little researched. Growth failure in terms of shortness and thinness should be differentiated, but not many studies have the data for this analysis.
Methods:
This is a longitudinal study of infants born in Lahore, Pakistan, between 1984 and 1987. Age at commencement of independent walking and age at 'building a 3-cube tower' were taken as indicators of gross and fine motor development, respectively. Size at birth was captured by length and thinness as continuous variables; postnatal growth from birth to 6 months of age was measured by changes in length and thinness. Adjustment for covariates and handling of censored cases were performed by generalized log gamma regression.
Results:
Thinness at birth and postnatal stunting and wasting had a linear, inverse association with gross motor development (each P < 0.05). Birth length had a non-linear, inverse association with this outcome (P < 0.05). Birth length, thinness at birth and postnatal wasting had a linear, inverse association with fine motor development (each P < 0.05).
Conclusion:
Both fetal and early postnatal growth over a broad spectrum may affect infants' motor development. It is not just the babies who were very small at birth that suffered. Birth length appeared to be more influential than other anthropometric indicators.