Growth and proportionality in early childhood. III. Differences between babies of low birthweight in well-nourished and malnourished populations.

The growth patterns from birth to 7 yr of four groups of children are compared. They comprise: small-for-gestational age children in a highly favoured community born to (A) short mothers, (B) mothers of average height for their population; Guatemalan children living in a community where mild to moderate protein-calorie malnutrition was endemic. Data on a sample of children whose birthweights covered the normal range for gestational age were used as reference standards. At all ages and for almost all measures they were significantly larger than children in the other three groups. No differences were found between the boys in groups A and B; but girls in group A were lighter and shorter from 18 mth onwards. The Guatemalans were shorter and had smaller heads than group A from 12 mth onwards; and the boys were also lighter. No differences were found between the Guatemalans and group A for chest circumference in either sex from 2 yr onwards. Deficits in size at 4 yr of the Guatemalans compared with the Reference Sample ranged from 8.8% for stature, 6.8% head circumference, 5.9% weight, down to 3.9% for chest circumference. The differences between the four groups may broadly be taken to represent those due to low birthweight for gestational age, lower genetic potential, postnatal malnutrition, and their cumulative effects. Our findings offer a new perspective on their varying contributions to growth in size and shape during early childhood.