Neonatal anthropometric indicators of infant growth and mortality in Burkina Faso
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Updated: Jul 17, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Mamadou Bountogo1, Ali Sié1, Alphonse Zakane1
1Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
Insights
Neonatal weight-for-age Z-score (WAZ) is a strong predictor of infant mortality and growth failure. Early screening using WAZ can identify high-risk infants for timely interventions.
Area of Science:
- Global Health
- Pediatric Nutrition
- Child Survival
Background:
- Undernutrition screening evidence primarily focuses on children 6-59 months.
- Highest mortality and wasting incidence occurs in the first 6 months of life.
- Limited data exists on neonatal predictors of infant mortality and growth failure.
Purpose of the Study:
- To evaluate the relationship between neonatal anthropometric indicators and mortality and growth at 6 months.
- To identify effective screening tools for early identification of at-risk infants.
Main Methods:
- Analysis of data from a randomized controlled trial in Burkina Faso.
- Logistic regression models used to assess associations between baseline anthropometry and 6-month outcomes.
- Included birth weight, WAZ, WLZ, LAZ, and MUAC as predictors.
Main Results:
- All anthropometric deficits at birth were associated with increased mortality by 6 months.
- Weight-for-age Z-score (WAZ) was the strongest predictor of mortality (aOR 3.91).
- Low WAZ also predicted wasting, stunting, and underweight at 6 months.
Conclusions:
- Weight-for-age Z-score (WAZ) is a valuable indicator for identifying infants at high risk of mortality.
- Screening protocols should incorporate WAZ for early detection of growth failure.
- Targeted interventions can improve outcomes for at-risk neonates.
Objective:
Most evidence supporting screening for undernutrition is for children aged 6-59 months. However, the highest risk of mortality and highest incidence of wasting occurs in the first 6 months of life. We evaluated relationships between neonatal anthropometric indicators, including birth weight, weight-for-age Z-score (WAZ), weight-for-length Z-score (WLZ), length-for-age Z-score (LAZ) and mid-upper arm circumference (MUAC) and mortality and growth at 6 months of age among infants in Burkina Faso.
Design:
Data arose from a randomised controlled trial evaluating neonatal azithromycin administration for the prevention of child mortality. We evaluated relationships between baseline anthropometric measures and mortality, wasting (WLZ < -2), stunting (LAZ < -2) and underweight (WAZ < -2) at 6 months of age were estimated using logistic regression models adjusted for the child's age and sex.
Setting:
Five regions of Burkina Faso.
Participants:
Infants aged 8-27 d followed until 6 months of age.
Results:
Of 21 832 infants enrolled in the trial, 7·9 % were low birth weight (<2500 g), 13·3 % were wasted, 7·7 % were stunted and 7·4 % were underweight at enrolment. All anthropometric deficits were associated with mortality by 6 months of age, with WAZ the strongest predictor (WAZ < -2 to ≥ -3 at enrolment v. WAZ ≥ -2: adjusted OR, 3·91, 95 % CI, 2·21, 6·56). Low WAZ was also associated with wasting, stunting, and underweight at 6 months.
Conclusions:
Interventions for identifying infants at highest risk of mortality and growth failure should consider WAZ as part of their screening protocol.
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