Sofiatin Yulia, Pusparani Asterlila, Judistiani Tina Dewi, Rahmalia Annisa, Diana Aly, Alisjahbana Anna
Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia.
Frontiers for Health Foundation, Indonesia.
Asia Pac J Clin Nutr. 2019;28(Suppl 1):S32-S42. doi: 10.6133/apjcn.201901_28(S1).0003.
Low birth weight leads to growth faltering, attributable inter alia to malnutrition and maternal health and literacy. Risk for growth faltering in rural children under five is studied.
The Risk Approach Strategy in Tanjungsari, West Java has been analysed for all pregnancies during 1988-1989 and 4,698 singleton infants born between 1 January 1988 and 31 April 1990. Weight and body length/height measurements were repeated over 60 months, and plotted against WHO standards. Weight-for-age and height-forage z-scores were calculated using 2006 WHO growth as reference. The correlation between shortness (so-called stunting) and its presumptive risk factors was determined. A subset underwent DNA analysis for insulin-like growth factor-1 (IGF-1), and insulin receptor substrate-1 (IRS-1) polymorphism.
Weight and body length/height follow-ups were followed-up for 3795 infants; 14.2% of the cohort had low birth weight (<2500 g) (LBW) and 85.8% normal birth weight (NBW). LBW infants showed a similar velocity but tended to catch up more slowly (GEE; p<0.001). Relative to WHO references, the differential for stature increased with age, largely offset by reduced weight-for-age so that weight-for-height tracked close to the WHO reference; this contrasts with more divergence internationally. Birth length and weight, along with potable water access were correlated with stunting for children under 2 years. Neither the observed IGF-1, IRS-1 or combined gene polymorphisms were associated with LBW.
The prediction by factors operative during pregnancy for early life stature, with some adaptation for LBW infants, endures to 60 months.
低出生体重会导致生长发育迟缓，这尤其归因于营养不良、孕产妇健康状况及识字水平。本研究对五岁以下农村儿童生长发育迟缓的风险进行了探究。
对西爪哇省丹戎萨里采用的风险评估策略进行了分析，研究对象为1988年至1989年期间所有怀孕情况以及1988年1月1日至1990年4月31日出生的4698名单胎婴儿。在60个月期间重复测量体重和身长/身高，并对照世界卫生组织标准绘制图表。以2006年世界卫生组织的生长标准为参考，计算年龄别体重和年龄别身高的z评分。确定了身材矮小（即所谓的发育迟缓）与其假定风险因素之间的相关性。对一部分研究对象进行了胰岛素样生长因子-1（IGF-1）和胰岛素受体底物-1（IRS-1）多态性的DNA分析。
对3795名婴儿进行了体重和身长/身高随访；该队列中14.2% 的婴儿出生体重低（<2500克）（低体重儿），85.8% 为正常出生体重（正常体重儿）。低体重儿的生长速度相似，但追赶速度往往较慢（广义估计方程；p<0.001）。相对于世界卫生组织的参考标准，身高差异随年龄增加，很大程度上被年龄别体重的降低所抵消，因此身高别体重接近世界卫生组织的参考标准；这与国际上更大程度上的差异形成对比。出生时身长和体重以及饮用水供应情况与2岁以下儿童的发育迟缓相关。观察到的IGF-1、IRS-1或联合基因多态性均与低体重儿无关。
孕期起作用的因素对生命早期身高的预测作用，在对低体重儿进行一定调整后，可持续至60个月。
