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Early growth velocity predicts longitudinal growth failure
Author(s) -
Ross Erin Sundseth,
Johnson Susan L,
Shroyer A. Laurie,
Prochazka Allan,
Dickinson L. Miriam,
Krebs Nancy,
Pharo Susan A
Publication year - 2008
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.22.1_supplement.874.10
Subject(s) - medicine , growth velocity , odds ratio , odds , pediatrics , longitudinal study , birth weight , demography , logistic regression , pregnancy , biology , pathology , sociology , genetics
Our primary objective was to evaluate whether a decline in growth trajectory, identified as a downward movement in z‐scores between the 4 and 6 month time period, can be used to predict later growth faltering, and whether the time period of 2 – 4 months is as effective of a predictor as the 4 – 6 month period. Longitudinal data from birth to 2 years of age were analyzed for 1978 healthy, term babies seen in a staff model HMO. The outcome variable was a weight‐for‐length ratio z‐score of ≤ −1.67, with measurements collected at 12, 18 and 24 months of age. The odds ratio (OR) for infants with a negative shift in z‐scores > −0.85 across the 4–6 month time period was 2.4 (95% CI 1.5, 3.9), and across the 2–4 month time period was 4.1 (95% CI 1.5, 11.4) compared to those without this shift, holding birthweight constant. Odds were increased as birth weight decreased, with an OR of 2.2 for infants <2.75kg, and an OR of 1.9 for infants ≥2.75kg, <3.0 kg, compared to infants 3.0 kg or heavier at birth. There was no significant difference between the 4–6 month (p=0.0006) or 2–4 month (p=0.0069) periods. Our findings support the hypothesis that a downward shift in growth velocity of this magnitude during early infancy can be used to identify children at‐risk of later poor growth. This information can be used to develop research studies and to support providers in decision‐making. Database development was supported by Kaiser‐Permanente of Colorado.