Factors Associated with Height Catch-Up and Catch-Down Growth Among Schoolchildren

Author(s)

Batista, Rosangela F. L. ^[1] ; Silva, Antonio A. M. ^[1] ; Barbieri, Marco A. ^[2] ; Simoes, Vanda M. F. ^[3] ; Bettiol, Heloisa ^[2]

Affiliation

^[1] Univ Fed Maranhao, Dept Saude Publ, Sao Luis, Maranhao - Brazil

^[2] Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Puericultura & Pediat, Sao Paulo - Brazil

^[3] Univ Fed Maranhao, Dept Med 1, Sao Luis, Maranhao - Brazil

• Document type: Journal article
• Source: PLoS One; v. 7, n. 3 MAR 12 2012.
• Web of Science Citations: 10

Abstract

In developed countries, children with intrauterine growth restriction (IUGR) or born preterm (PT) tend to achieve catch-up growth. There is little information about height catch-up in developing countries and about height catch-down in both developed and developing countries. We studied the effect of IUGR and PT birth on height catch-up and catch-down growth of children from two cohorts of liveborn singletons. Data from 1,463 children was collected at birth and at school age in Ribeirao Preto (RP), a more developed city, and in Sao Luis (SL), a less developed city. A change in z-score between schoolchild height z-score and birth length z-score >= 0.67 was considered catch-up; a change in z-score <=-0.67 indicated catch-down growth. The explanatory variables were: appropriate weight for gestational age/PT birth in four categories: term children without IUGR (normal), IUGR only (term with IUGR), PT only ( preterm without IUGR) and preterm with IUGR; infant's sex; maternal parity, age, schooling and marital status; occupation of family head; family income and neonatal ponderal index (PI). The risk ratio for catch-up and catch-down was estimated by multinomial logistic regression for each city. In RP, preterms without IUGR (RR = 4.13) and thin children (PI<10th percentile, RR = 14.39) had a higher risk of catch-down; catch-up was higher among terms with IUGR (RR = 5.53), preterms with IUGR (RR = 5.36) and children born to primiparous mothers (RR = 1.83). In SL, catch-down was higher among preterms without IUGR (RR = 5.19), girls (RR = 1.52) and children from low-income families ( RR = 2.74); the lowest risk of catch-down (RR = 0.27) and the highest risk of catch-up (RR = 3.77) were observed among terms with IUGR. In both cities, terms with IUGR presented height catch-up growth whereas preterms with IUGR only had height catch-up growth in the more affluent setting. Preterms without IUGR presented height catch-down growth, suggesting that a better socioeconomic situation facilitates height catch-up and prevents height catch-down growth. (AU)

• FAPESP's process: 00/09508-7 - From perinatal health to health of the young adult: study of cohort born in 1978/79 in the hospitals of Ribeirão Preto, SP
• Grantee: Marco Antonio Barbieri
• Support Opportunities: Research Projects - Thematic Grants