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Growth outcomes of weight faltering in infancy in ALSPAC
Zia ud Din1, Pauline Emmett, Colin Steer
1Department of Human Nutrition, KP Agricultural University, Peshawar, Pakistan.
Insights
Infants with early weight faltering (before 8 weeks) catch up in weight but not height, achieving normal adult anthropometrics. Later weight faltering results in slower catch-up growth, with individuals remaining shorter and lighter.
Area of Science:
- Pediatric Growth and Development
- Nutritional Pediatrics
- Longitudinal Cohort Studies
Background:
- Weight faltering in term infants is a concern for long-term growth.
- Understanding different patterns of catch-up growth is crucial for clinical management.
- The Avon Longitudinal Study of Parents and Children (ALSPAC) provides valuable data on child development.
Purpose of the Study:
- To investigate and compare growth outcomes in term infants experiencing weight faltering at different developmental stages.
- To analyze catch-up growth trajectories and final anthropometric profiles in infants with early versus late weight faltering.
- To determine if infants with weight faltering achieve normal growth parameters by adolescence.
Main Methods:
- Conditional weight gain was calculated for term infants in the ALSPAC cohort.
- Weight faltering was defined as conditional weight gain below the fifth centile.
- Growth measurements included weight, length/height, BMI, mid-arm, and waist circumference from infancy to 13 years.
Main Results:
- Early weight faltering (before 8 weeks) led to enhanced weight gain until age 2, with proportional height gain lagging. By 13 years, BMI and circumferences were similar to controls.
- Late weight faltering (8 weeks to 9 months) resulted in steady weight gain, with enhanced gain between 7-10 years. Height gain was proportional, but individuals remained lighter and shorter than controls at 13 years.
- Two distinct catch-up growth patterns were observed based on the timing of weight faltering.
Conclusions:
- The timing of weight faltering significantly influences catch-up growth patterns and long-term anthropometric outcomes in term infants.
- Infants with early weight faltering exhibit a different catch-up trajectory compared to those with later onset.
- By 13 years, individuals with early weight faltering achieved anthropometric profiles within population norms, unlike those with late faltering.
Objective:
The goal of this study was to investigate growth outcomes in term infants with weight faltering.
Methods:
Conditional weight gain was calculated on term infants from the Avon Longitudinal Study of Parents and Children. Cases of weight faltering were infants with a conditional weight gain below the fifth centile. Outcome growth measurements included weight and length/height (from 9 months to 13 years), BMI, mid-arm circumference, and waist circumference (at 7, 10, and 13 years).
Results:
Weight data were available on 11 499 infants; 507 had "early" weight faltering (before 8 weeks), and 480 had "late" weight faltering (between 8 weeks and 9 months). The early group showed enhanced weight gain from 8 weeks until 2 years, then gained weight at the same rate as the controls. Gain in height was proportionally slower than gain in weight through childhood. By 13 years, they had BMI, mid-arm circumference, and waist circumference similar to the controls. The late group showed steady weight gain throughout childhood; enhanced weight gain compared with the controls only occurred between 7 and 10 years. Gain in height was proportional to gain in weight. This group remained considerably lighter and shorter than the controls up to the age of 13 years.
Conclusions:
Children with weight faltering before 8 weeks showed a different pattern of "catch-up" to those with weight faltering later in infancy. By 13 years, the anthropometric profile of the 2 groups was within population norms.
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