Growth status of small for gestational age Indian children from two socioeconomic strata

Area of Science:

• Pediatric Growth and Development
• Public Health Nutrition
• Socioeconomic Determinants of Health

Background:

• Children born small for gestational age (SGA) often face growth challenges.
• Socioeconomic disparities can significantly influence child development outcomes.
• Understanding growth trajectories in SGA children across different socioeconomic strata is crucial for public health.

Purpose of the Study:

• To compare growth patterns in children born small for gestational age (SGA) from upper (USS) and lower (LSS) socioeconomic strata.
• To identify factors associated with growth and stunting in SGA children.
• To provide a benchmark against healthy, appropriate-for-gestational-age controls.

Main Methods:

• A retrospective study involving 618 children (0.5-5 years) from two hospitals in Pune.
• Included 189 SGA from USS, 217 SGA from LSS, and 212 healthy controls.
• Anthropometric data (height, weight) were collected and converted to Z-scores (HAZ, WAZ) using WHO AnthroPlus software.

Main Results:

• SGA children demonstrated significantly lower height-for-age Z-scores (HAZ) and weight-for-age Z-scores (WAZ) compared to controls.
• LSS-SGA children had poorer growth metrics than USS-SGA children (P < 0.05).
• Stunting rates were higher in LSS (49%) vs. USS (32%) SGA children. Factors like normal vaginal delivery and maternal age were positively associated with growth, while high SES, absence of major illness, and higher birth weight were negatively associated with stunting risk.

Conclusions:

• Children born SGA experience impaired growth relative to their peers.
• Lower socioeconomic strata, very low birth weight, and significant early childhood illnesses are critical factors impacting SGA child growth.
• Targeted monitoring and interventions are essential for SGA children, particularly those from disadvantaged backgrounds and with co-existing health issues.