Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Rd NE, #748, Emory University, Atlanta, GA 30322, USA.
Am J Hum Biol. 2010 May-Jun;22(3):353-9. doi: 10.1002/ajhb.20998.
Growth failure is cumulative, and short stature is associated with multiple indices of reduced human capital. Few studies have been able to address in a single analysis both consideration of the timing of growth failure and comparison across populations. We analyzed data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa (n = 4,659). We used data on length at birth (available for three of the five cohorts), 12 mo, 24 mo, and mid-childhood to construct cohort- and sex- specific conditional length measures. We modeled adult height as a function of conditional length in childhood. The five cohorts experienced varying degrees of growth failure. As adults, the Brazil sample was 0.35 +/- 0.89 standard deviations (SD) below the World Health Organization reference, while adult Guatemalans were 1.91 +/- 0.87 SD below the reference. All five cohorts experienced a nadir in height for age Z-score at 24 mo. Birth length (in the three cohorts with this variable), and conditional length at 12 mo (in all five cohorts) were the most strongly associated with adult height. Growth in the periods 12-24 mo and 24 mo to mid-childhood showed inconsistent patterns across tertiles of adult height. Despite variation in the magnitude of cumulative growth failure across cohorts, the five cohorts show highly consistent age-specific associations with adult stature. Growth failure prior to age 12 mo was most strongly associated with adult stature. These consistencies speak to the importance of interventions to address intrauterine growth failure and growth failure in the first 12 mo of life.
生长发育迟缓是累积性的，身材矮小与多种人力资本降低的指标有关。很少有研究能够在单一分析中同时考虑生长发育迟缓的时间和不同人群的比较。我们分析了来自巴西、危地马拉、印度、菲律宾和南非的出生队列数据（n=4659）。我们使用了出生时（五个队列中的三个有此数据）、12 个月、24 个月和儿童中期的长度数据来构建队列和性别特异性的条件长度测量值。我们将成年身高建模为儿童时期条件长度的函数。五个队列经历了不同程度的生长发育迟缓。作为成年人，巴西样本比世界卫生组织参考值低 0.35 +/- 0.89 个标准差，而成年危地马拉人比参考值低 1.91 +/- 0.87 个标准差。所有五个队列在 24 个月时的身高年龄 Z 分数都达到了最低点。出生时的长度（在有此变量的三个队列中）和 12 个月时的条件长度（在所有五个队列中）与成年身高最密切相关。12-24 个月和 24 个月到儿童中期的生长发育在成年身高的三分位数中呈现出不一致的模式。尽管各队列累积生长发育迟缓的程度存在差异，但五个队列在与成年身高相关的年龄特异性方面表现出高度一致性。12 个月前的生长发育迟缓与成年身高的相关性最强。这些一致性表明，干预措施对于解决宫内生长发育迟缓以及生命最初 12 个月的生长发育迟缓至关重要。
