Maternal and environmental risk for faltered growth in the first 5 years for Tanjungsari children in West Java, Indonesia

Yulia Sofiatin ； Asterlila Pusparani ； Tina Dewi Judistiani ； Annisa Rahmalia ； Aly Diana ； Anna Alisjahbana

《Asia Pacific Journal of Clinical Nutrition》 28卷S1期 (2019/01) Pp. s32-s42

https://doi.org/10.6133/apjcn.201901_28(S1).0003

摘要

Background and Objectives: 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. Study Design: 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. Results: 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 Conclusions: The prediction by factors operative during pregnancy for early life stature, with some adaptation for LBW infants, endures to 60 months.

關鍵字

birth weight ； postnatal growth ； stunting ； shortness ； birth length ； water quality ； Tanjungsari cohort