Aryeh D. Stein, Meng Wang, Reynaldo Martorell, Shane A. Norris, Linda S. Adair, Isabelita Bas, Harshpal Singh Sachdev, Santosh K. Bhargava, Caroline H. D. Fall, Denise P. Gigante, Cesar G. Victora
Growth failure is cumulative, and short stature is associated with multiple indices of reduced human capital. Few studies have been able to address in a single analysis both consideration of the timing of growth failure and comparison across populations. We analyzed data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa (n = 4,659). We used data on length at birth (available for three of the five cohorts), 12 mo, 24 mo, and mid-childhood to construct cohort-and sex-specific conditional length measures. We modeled adult height as a function of conditional length in childhood. The five cohorts experienced varying degrees of growth failure. As adults, the Brazil sample was 0.35 ± 0.89 standard deviations (SD) below the World Health Organization reference, while adult Guatemalans were 1.91 ± 0.87 SD below the reference. All five cohorts experienced a nadir in height for age Z-score at 24 mo. Birth length (in the three cohorts with this variable), and conditional length at 12 mo (in all five cohorts) were the most strongly associated with adult height. Growth in the periods 12-24 mo and 24 mo to mid-childhood showed inconsistent patterns across tertiles of adult height. Despite variation in the magnitude of cumulative growth failure across cohorts, the five cohorts show highly consistent age-specific associations with adult stature. Growth failure prior to age 12 mo was most strongly associated with adult stature. These consistencies speak to the importance of interventions to address intrauterine growth failure and growth failure in the first 12 mo of life. © 2009 Wiley-Liss, Inc.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Birth to Twenty Research Programme, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Office of Population Studies Foundation, University of San Carlos, Cebu, Philippines; Department of Pediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi, India; Department of Pediatrics, S.L. Jain Hospital, Delhi, India; MRC, Epidemiology Resource Centre, University of Southampton, Southampton, United Kingdom; Universidade Federal de Pelotas, Pelotas, Brazil
