Early determinants of linear growth and weight attained in the first year of life in a malaria endemic region

PLoS One. 2019 Aug 6;14(8):e0220513. doi: 10.1371/journal.pone.0220513. eCollection 2019.

Abstract

We investigated linear growth and weight attained among 772 children at 10-15 months of age in the first population-based birth cohort in the Brazilian Amazon. Sociodemographic, maternal and birth characteristics were collected in interviews soon after birth at baseline. Anthropometric evaluation was conducted at 10-15 months. Multiple linear regression models were fitted for length-for-age (LAZ) and body mass index (BMI)-for-age Z scores (BAZ), considering a hierarchical conceptual framework with determinants at distal, intermediate and proximal levels, with adjustment for the child's sex and age. Mean LAZ and BAZ were 0.31 (SD: 1.13) and 0.35 (SD: 1.06), respectively. Overall, 2.2% of children were stunted and 6.6% overweight. Among socioeconomic factors, household wealth index was positively associated with LAZ (p for trend = 0.01), while children whose families received assistance from the Bolsa Família conditional cash transfer program were 0.16 Z score thinner (95% CI: -0.31, -0.00). Maternal height and BMI were positively associated with both LAZ and BAZ at 10-15 months of age (p for trend <0.001). Child's size at birth was positively related with LAZ (p<0.001 for both birth weight and length). BAZ was 0.34 (95% CI: 0.24, 0.44) higher, but 0.11 lower (95% CI: -0.21, -0.02), for each increase in 1 Z score of birth weight and length, respectively. Children with at least one reported malaria episode within the first year of life were 0.58 (95% CI: -1.05, -0.11) Z score shorter. Socioeconomic and intergenerational factors were consistently associated with LAZ and BAZ at 10-15 months of age. The occurrence of malaria was detrimental to linear growth. In a malaria endemic region, reduction of inequalities and disease burden over the first 1,000 days of life is essential for taking advantage of a critical window of opportunity that can redirect child growth trajectories toward better health and nutrition conditions in the long term.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Anthropometry / methods*
  • Body Height / physiology*
  • Body Mass Index*
  • Brazil
  • Endemic Diseases
  • Female
  • Humans
  • Infant
  • Malaria / physiopathology*
  • Male
  • Nutritional Status
  • Socioeconomic Factors

Grants and funding

The present study was funded by the Brazilian National Council of Technological and Scientific Development, CNPq (http://cnpq.br/ -- grant 407255/2013-3; M.A.C., M.C.C.), the São Paulo Research Foundation, FAPESP (http://fapesp.br/ -- grant 2016/00270-6; M.A.C.) and the Maria Cecilia Souto Vidigal Foundation (http://www.fmcsv.org.br/ -- M.C.C.). This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES -- http://www.capes.gov.br/) – Finance Code 001, with a masters scholarship to J.P.D.B. The views expressed in the present article are those of the authors and not necessarily those of any funding agencies. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.