Ali Rahma, Zinab Beakal, Megersa Bikila S, Yilma Daniel, Girma Tsinuel, Abdissa Alemseged, Berhane Melkamu, Admasu Bitiya, Filteau Suzanne, Nitsch Dorothea, Friis Henrik, Wells Jonathan C K, Andersen Gregers S, Abera Mubarek, Olsen Mette F, Wibaek Rasmus, Marphatia Akanksha A
Department of Population and Family health, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
BMC Public Health. 2024 Dec 18;24(1):3417. doi: 10.1186/s12889-024-20875-1.
Childhood is a period marked by dynamic growth. Evidence of the association between childhood linear growth and school achievement comes mostly from cross-sectional data. We assessed associations between birth length, childhood linear growth velocities, and stunting with school achievement.
Newborns were recruited into the Ethiopian infant Anthropometry and Body Composition (iABC) birth cohort and followed from birth to 10 years. Velocities from 0 to 6 years were computed using linear spline mixed effect modelling. Stunting (height-for-age < -2 z-scores) was assessed at the ages of 1, 2, 4, 5, and 6 years. School achievement was measured by having a high (≥ 80%) combined high math, English, and science (MES) score and being at appropriate grade-for-age. Logistic regression models assessed associations between birth length, linear growth velocities and stunting with school achievement.
Children's mean age was 9.8 years (standard deviation, SD 1.0, range 7-12 years). A 1 SD greater birth length increased the odds of achieving a high MES combined score by 1.42 (95% CI: 0.99, 2.03). A 1 SD increase in linear growth velocity from 6 to 24 months increased the odds of being in the appropriate grade-for-age by 1.66 (95% CI: 1.14, 2.43). Stunting at ages 4 and 6 years was associated with lower odds of achieving a high MES combined score: 0.43 (95% CI: 0.20, 0.93) and 0.31 (95% CI: 0.11, 0.89), respectively. Faster post-natal linear growth was not associated with school achievement.
Greater birth length and higher growth velocity from 6 to 24 months were associated with higher school achievement and being in the appropriate grade-for-age, respectively. Children who experienced growth failure were less likely to achieve a high MES score. Interventions aimed at improving school achievement should address maternal and fetal nutrition and health, and monitor post-natal growth.
儿童期是一个以动态生长为特征的时期。儿童期线性生长与学业成绩之间关联的证据主要来自横断面数据。我们评估了出生身长、儿童期线性生长速度以及发育迟缓与学业成绩之间的关联。
将新生儿纳入埃塞俄比亚婴儿人体测量与身体成分（iABC）出生队列，并从出生随访至10岁。使用线性样条混合效应模型计算0至6岁的生长速度。在1、2、4、5和6岁时评估发育迟缓情况（身高别年龄＜-2 z评分）。学业成绩通过高（≥80%）的数学、英语和科学综合成绩（MES）以及处于适龄年级来衡量。逻辑回归模型评估出生身长、线性生长速度和发育迟缓与学业成绩之间的关联。
儿童的平均年龄为9.8岁（标准差，SD 1.0，范围7 - 12岁）。出生身长每增加1个标准差，获得高MES综合成绩的几率增加1.42（95%置信区间：0.99，2.03）。6至24个月线性生长速度每增加1个标准差，处于适龄年级的几率增加1.66（95%置信区间：1.14，2.43）。4岁和6岁时的发育迟缓与获得高MES综合成绩的较低几率相关，分别为0.43（95%置信区间：0.20，0.93）和0.31（95%置信区间：0.11，0.89）。出生后更快的线性生长与学业成绩无关。
出生时身长更长以及6至24个月时生长速度更快分别与更高的学业成绩和处于适龄年级相关。经历生长发育不良的儿童获得高MES成绩的可能性较小。旨在提高学业成绩的干预措施应关注孕产妇和胎儿营养与健康，并监测出生后的生长情况。
