Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil.
Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação Nutrição em Saúde Pública. São Paulo, SP, Brasil.
Rev Saude Publica. 2024 Feb 26;57Suppl 2(Suppl 2):3s. doi: 10.11606/s1518-8787.2023057005628. eCollection 2024.
To investigate birth-to-childhood tracking of linear growth and weight gain across the distribution of length/height and weight for age z-scores and according to household wealth.
Data from 614 children from the MINA-Brazil Study with repeated anthropometric measurements at birth and up to age five years were used. Z-scores were calculated for length/height (HAZ) and weight (WAZ) according to international standards. Birth-to-childhood tracking was separately estimated using quantile regression models for HAZ and WAZ, extracting coefficients and 95% confidence intervals (95%CI) at the 25th, 50th, and 75th quantiles. In a subgroup analysis, we estimated tracking between birth and age two years, and between ages two and five years. To investigate disparities in tracking, interaction terms between household wealth indexes (at birth and age five years) and newborn size z-scores were included in the models.
Tracking coefficients were significant and had similar magnitude across the distribution of anthropometric indices at age five years (HAZ, 50th quantile: 0.23, 95%CI: 0.11 to 0.35; WAZ, 50th quantile: 0.31, 95%CI: 0.19 to 0.43). Greater tracking was observed between ages two and five years, with coefficients above 0.82. Significantly higher tracking of linear growth was observed among children from wealthier households, both at birth, at the lower bounds of HAZ distribution (25th quantile: 0.30, 95%CI: 0.13 to 0.56), and during childhood, in the entire HAZ distribution at five years. For weight gain, stronger tracking was observed at the upper bounds of WAZ distribution at age five years among children from wealthier households at birth (75th quantile: 0.59, 95%CI: 0.35 to 0.83) and during childhood (75th quantile: 0.54, 95%CI: 0.15 to 0.93).
There was significant tracking of HAZ and WAZ since birth, with indication of substantial stability of nutritional status between ages two and five years. Differential tracking according to household wealth should be considered for planning early interventions for preventing malnutrition.
研究线性生长和体重增长在按年龄身高 Z 分数和家庭财富分布的情况下从出生到儿童期的追踪情况。
使用 MINA-Brazil 研究的 614 名儿童的数据，这些儿童在出生时和 5 岁前进行了重复的人体测量。根据国际标准计算身高（HAZ）和体重（WAZ）的 Z 分数。使用分位数回归模型分别估计 HAZ 和 WAZ 的出生至儿童期的追踪情况，提取第 25、50 和 75 分位数的系数和 95%置信区间（95%CI）。在亚组分析中，我们估计了出生至 2 岁和 2 至 5 岁之间的追踪情况。为了研究追踪的差异，在模型中包含了家庭财富指数（出生时和 5 岁时）和新生儿大小 Z 分数之间的交互项。
在 5 岁时的人体测量指数分布中，追踪系数显著且大小相似（HAZ，第 50 分位数：0.23，95%CI：0.11 至 0.35；WAZ，第 50 分位数：0.31，95%CI：0.19 至 0.43）。在 2 至 5 岁之间观察到更大的追踪，系数高于 0.82。在更富裕家庭的儿童中，线性生长的追踪更为明显，无论是在出生时 HAZ 分布的较低界限（第 25 分位数：0.30，95%CI：0.13 至 0.56），还是在整个 HAZ 分布中，在 5 岁时，都观察到了较高的追踪。对于体重增加，在出生时家庭更富裕的儿童中，WAZ 分布的上限在 5 岁时观察到更强的追踪（第 75 分位数：0.59，95%CI：0.35 至 0.83）和整个童年时期（第 75 分位数：0.54，95%CI：0.15 至 0.93）。
从出生开始，HAZ 和 WAZ 就有显著的追踪，表明 2 至 5 岁之间营养状况的稳定性很高。应根据家庭财富考虑差异追踪，为预防营养不良制定早期干预措施。
