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Association between size at birth, paediatric diarrhoeal incidence and postnatal growth
1Department of Paediatrics, Clinical Trials Centre, Faculty of Medicine, University of Hong Kong, Pokfulam, SAR, PR China.
Insights
Infant diarrhea incidence is not linked to birth size. However, diarrhea can negatively impact infant growth, particularly between 18-24 months, affecting body size at 24 months.
Area of Science:
- Pediatrics
- Global Health
- Nutritional Epidemiology
Background:
- Infant growth and diarrheal diseases are critical public health concerns in developing countries.
- Understanding the relationship between early life growth and subsequent health outcomes is essential for targeted interventions.
Purpose of the Study:
- To investigate the association between infant size at birth and diarrheal incidence up to 24 months of age.
- To examine the association between diarrheal incidence and body size at 24 months of age.
Main Methods:
- A longitudinal study of 1476 infants in Lahore, Pakistan (1984-1987).
- Monthly enumeration of diarrheal incidence.
- Generalized estimating equations with Poisson regression and multiple linear regression analyses were used.
Main Results:
- Birth length standard deviation score (SDS) and ponderal index at birth were not significantly associated with diarrheal incidence.
- Diarrheal incidence was significantly associated with weight SDS and body mass index at 24 months (p < 0.05).
- Height SDS at 24 months was not significantly associated with diarrheal incidence (p > 0.05).
Conclusions:
- Preventing low birth weight is unlikely to reduce infant diarrheal incidence.
- Controlling diarrheal incidence may not substantially improve infant growth in developing countries.
Unlabelled:
This study tests the hypothesis that size at birth is associated with diarrhoeal incidence from birth to 24 mo of age, and the hypothesis that diarrhoeal incidence from birth to 24 mo is associated with body size at age 24 mo. This is a longitudinal study of 1476 infants born in Lahore. Pakistan, in 1984-1987. Diarrhoeal incidence was enumerated monthly. A generalized estimating equations approach with Poisson regression showed that birthlength standard deviation score (SDS) and ponderal index at birth (rate ratio = 1.01 and 1.00; each p > 0.05) were not significantly associated with diarrhoeal incidence. Multiple linear regression showed that diarrhoeal incidence was significantly associated with weight SDS and body mass index at 24 mo (regression coefficient or beta = -0.58 and -1.02: each p < 0.05). but not with height SDS (beta = -0.10: p > 0.05). The associations were mainly due to a transient effect of diarrhoea in the period 18-24 mo.
Conclusion:
Prevention of low birthweight is unlikely to have an impact on diarrhoeal incidence in infants. Control of diarrhoeal incidence may not improve the growth of infants in developing countries.