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Determinants of Catch-up Growth in Early Childhood: A Longitudinal Study
Avliya Quratul Marjan1,2, Ratu Ayu Dewi Sartika2, Endang Laksminingsih2
1Nutrition Study Program, Faculty of Health Sciences, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia.
Insights
Catch-up growth in early childhood is crucial for preventing stunting. Male sex and maternal nutritional status significantly influence a child's ability to achieve catch-up growth after early life malnutrition.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Early childhood growth failure, particularly in the first 1000 days, significantly impacts long-term health.
- Stunting, measured by height for age z-score (HAZ), is a key indicator of nutritional problems and impaired linear growth.
- Catch-up growth is essential for mitigating the adverse effects of early malnutrition and improving linear growth trajectories.
Purpose of the Study:
- To identify factors influencing catch-up growth in early childhood.
- To analyze the relationship between various child, parent, and household factors and catch-up growth based on HAZ.
- To provide insights for interventions aimed at improving child growth outcomes.
Main Methods:
- A three-year cohort study utilizing secondary data from the Indonesian Family Life Survey (IFLS).
- Inclusion of 537 children aged 0-23 months at baseline (1997), with follow-up data at 3-5 years old (2000).
- Statistical analyses included Chi-squared tests for bivariate analysis and multinomial logistic regression for multivariate analysis to determine influential factors.
Main Results:
- Bivariate analysis indicated significant associations between catch-up growth and normal birth weight, normal head circumference, normal maternal nutritional status, and maternal height.
- Multivariate analysis revealed that male sex (p=0.003) and maternal nutritional status (p=0.011) were the most significant determinants of catch-up growth.
- Stunting with catch-up growth was more prevalent in males, and poor maternal nutrition was linked to stunting and failed catch-up growth.
Conclusions:
- Regular monitoring of child growth and development is vital, especially for identifying stunting and facilitating catch-up growth.
- Interventions targeting maternal nutritional status are crucial for preventing stunting and promoting catch-up growth in early childhood.
- Factors such as sex, maternal nutritional status, head circumference, breastfeeding, maternal height, and gestational age influence different growth trajectories, including late stunting and failure to catch up.
Background:
Growth failure in the first 1000 days of life can have a major impact on a child's health. Therefore, catching up on growth in early childhood is essential to prevent nutritional problems, especially stunting, as indicated by the height for age z-score (HAZ). Catch-up growth after a period of malnutrition in the first 1000 days of life can be measured as an improvement in linear growth using HAZ parameters.
Objective:
This study aimed to determine the factors that influence catch-up growth in early childhood based on the HAZ.
Methods:
This three-year cohort study used two waves of secondary data from the Indonesian Family Life Survey (IFLS). Baseline data of the study were taken in 1997 when the children were 0 to 23 months old, then followed up in 2000 (at 3 to 5 years old). The study included 537 children aged 0 to 23 months in 1997. The dependent variable was catch-up growth. The independent variables were: children-related, parent-related, and household factors. We collected secondary data from the IFLS annual report book. Bivariate data analysis was performed using the Chi-squared test, while multivariate analysis was performed using multinomial logistic regression.
Results:
There were four groups in this study: not stunted (reference group), stunted catch-up, stunted non-catch-up, and late incident stunted. Bivariate analysis showed that catch-up growth, based on HAZ, was significantly influenced by birth weight (normal birth weight), head circumference (normal head circumference), maternal nutritional status (normal), and maternal height (p <0.05). After controlling for potentially confounding factors, sex (p = 0.003; 95% CI:1.43-5.93) and maternal nutritional status (p = 0.011; 95% CI:0.19-0.81) were the most influential factors on catch-up growth in early childhood.
Conclusion:
Children with stunting and catch-up growth are more common among males, and poor maternal nutritional status was associated with stunting and failure to achieve catch-up growth. The determining factors for the late incident and stunted non-catch-up groups include head circumference, breastfeeding status, maternal height, and maternal nutritional status. The stunted non-catch-up group is also influenced by small gestational age (SGA). Therefore, it is important to regularly monitor the growth and development of children in early childhood.
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