Public Health Nutrition Program, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, São Paulo, SP 01246-904, Brazil.
BMC Public Health. 2012 Jun 11;12:265. doi: 10.1186/1471-2458-12-265.
Although linear growth during childhood may be affected by early-life exposures, few studies have examined whether the effects of these exposures linger on during school age, particularly in low- and middle-income countries.
We conducted a population-based longitudinal study of 256 children living in the Brazilian Amazon, aged 0.1 y to 5.5 y in 2003. Data regarding socioeconomic and maternal characteristics, infant feeding practices, morbidities, and birth weight and length were collected at baseline of the study (2003). Child body length/height was measured at baseline and at follow-up visits (in 2007 and 2009). Restricted cubic splines were used to construct average height-for-age Z score (HAZ) growth curves, yielding estimated HAZ differences among exposure categories at ages 0.5 y, 1 y, 2 y, 5 y, 7 y, and 10 y.
At baseline, median age was 2.6 y (interquartile range, 1.4 y-3.8 y), and mean HAZ was -0.53 (standard deviation, 1.15); 10.2% of children were stunted. In multivariable analysis, children in households above the household wealth index median were 0.30 Z taller at age 5 y (P = 0.017), and children whose families owned land were 0.34 Z taller by age 10 y (P = 0.023), when compared with poorer children. Mothers in the highest tertile for height had children whose HAZ were significantly higher compared with those of children from mothers in the lowest height tertile at all ages. Birth weight and length were positively related to linear growth throughout childhood; by age 10 y, children weighing >3500 g at birth were 0.31 Z taller than those weighing 2501 g to 3500 g (P = 0.022) at birth, and children measuring ≥51 cm at birth were 0.51 Z taller than those measuring ≤48 cm (P = 0.005).
Results suggest socioeconomic background is a potentially modifiable predictor of linear growth during the school-aged years. Maternal height and child's anthropometric characteristics at birth are positively associated with HAZ up until child age 10 y.
尽管儿童期的线性生长可能受到生命早期暴露的影响，但很少有研究检查这些暴露对学校年龄的影响是否持续存在，尤其是在中低收入国家。
我们对生活在巴西亚马逊地区的 256 名儿童进行了一项基于人群的纵向研究，这些儿童在 2003 年时的年龄为 0.1 岁至 5.5 岁。在研究的基线阶段（2003 年）收集了关于社会经济和产妇特征、婴儿喂养方式、发病率以及出生体重和长度的数据。在基线和随访（2007 年和 2009 年）时测量了儿童的身体长度/身高。使用限制立方样条构建平均身高年龄 Z 评分（HAZ）生长曲线，得出暴露类别在 0.5 岁、1 岁、2 岁、5 岁、7 岁和 10 岁时的估计 HAZ 差异。
在基线时，中位年龄为 2.6 岁（四分位距，1.4 岁-3.8 岁），平均 HAZ 为-0.53（标准差，1.15）；10.2%的儿童身材矮小。在多变量分析中，家庭财富指数中位数以上的家庭的儿童在 5 岁时身高高 0.30 Z（P=0.017），家庭拥有土地的儿童在 10 岁时身高高 0.34 Z（P=0.023），与较贫困的儿童相比。身高最高三分位的母亲所生孩子的 HAZ 明显高于身高最低三分位母亲所生孩子在所有年龄的 HAZ。出生体重和长度与整个儿童期的线性生长呈正相关；到 10 岁时，出生体重超过 3500 克的儿童比出生体重为 2501 克至 3500 克的儿童身高高 0.31 Z（P=0.022），出生时身长超过 51 厘米的儿童比出生时身长低于 48 厘米的儿童身高高 0.51 Z（P=0.005）。
结果表明，社会经济背景是学校年龄线性生长的潜在可改变预测因子。母亲的身高和儿童出生时的人体测量特征与 HAZ 呈正相关，直至儿童 10 岁。
