Sociodemographic predictors of early postnatal growth: evidence from a Chilean infancy cohort

• Published in: BMJ open Vol. 10; no. 6; p. e033695
• Main Authors: Von Holle, Ann, North, Kari E, Gahagan, Sheila, Burrows, Raquel A, Blanco, Estela, Lozoff, Betsy, Howard, Annie Green, Justice, Anne, Graff, Misa, Voruganti, Venkata Saroja
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 03.06.2020; BMJ Publishing Group
• Series: Original research
• Subjects: Age; Anemia; Anemia, Iron-Deficiency - epidemiology; Anemia, Iron-Deficiency - prevention & control; Anthropometry; Babies; Breastfeeding & lactation; Child Development; Childrens health; Chile; Chronic illnesses; Disease prevention; Education; Environmental indicators; Epidemiology; Female; Growth models; Humans; Income; Infant; Infant, Newborn; Infants; Iron; Low income groups; Male; Mothers; Poverty Areas; Prospective Studies; Public health; Sociodemographics; Socioeconomic Factors; Socioeconomics; Variables; Velocity; Chile; epidemiology; public health; community child health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2019-033695

ObjectivesInfant anthropometric growth varies across socioeconomic factors, including maternal education and income, and may serve as an indicator of environmental influences in early life with long-term health consequences. Previous research has identified sociodemographic gradients in growth with a focus on the first year and beyond, but estimates are sparse for growth before 6 months. Thus, our objective was to examine the relationship between sociodemographic factors and infant growth patterns between birth and 5 months of age.DesignProspective cohort study.SettingsLow-income to middle-income neighbourhoods in Santiago, Chile (1991–1996).Participants1412 participants from a randomised iron-deficiency anaemia preventive trial in healthy infants.Main outcome measuresLongitudinal anthropometrics including monthly weight (kg), length (cm) and weight-for-length (WFL) values. For each measure, we estimated three individual-level growth parameters (size, timing and velocity) from SuperImposition by Translation and Rotation models. Size and timing changes represent vertical and horizontal growth curve shifts, respectively, and velocity change represents growth rate shifts. We estimated the linear association between growth parameters and gestational age, maternal age, education and socioeconomic position (SEP).ResultsLower SEP was associated with a slower linear (length) velocity growth parameter (−0.22, 95% CI –0.31 to –0.13)—outcome units are per cent change in velocity from the average growth curve. Lower SEP was associated with later WFL growth timing as demonstrated through the tempo growth parameter for females (0.25, 95% CI 0.05 to 0.42)—outcome units are shifts in days from the average growth curve. We found no evidence of associations between SEP and the weight size, timing or velocity growth rate parameters.ConclusionPrevious research on growth in older infants and children shows associations between lower SEP with slower length velocity. We found evidence supporting this association in the first 5 months of life, which may inform age-specific prevention efforts aimed at infant length growth.