Birth Status, Child Growth, and Adult Outcomes in Low- and Middle-Income Countries

• Type of Material: Article
• Authors: Aryeh Stein, Emory University; Fernando C. Barros, Universidade Católica de Pelotas; Santosh K. Bhargava, S.L. Jain Hospital; Wei Hao, Emory University; Bernardo L. Horta, Universidade Federal de Pelotas; Nanette Lee, University of San Carlos; Christopher W. Kuzawa, Northwestern University; Reynaldo Martorell, Emory University; Siddarth Ramji, Maulana Azad Medical College; Alan Stein, University of Oxford; Linda Richter, University of Witwatersrand
• Language: English
• Date: 2013-12-01
• Publisher: Elsevier: 12 months
• Publication Version: Final Published Version
• Copyright Statement: © 2013 Mosby Inc. All rights reserved.
• License: Creative Commons Attribution 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jpeds.2013.08.012
• Title of Journal or Parent Work: Journal of Pediatrics
• ISSN: 0022-3476
• Volume: 163
• Issue: 6
• Start Page: 1740
• End Page: U302
• Grant/Funding Information: Additional funding for data analysis for this paper was provided by the Bill and Melinda Gates Foundation (OPP1020058).; Funding for the individual cohorts was as follows: Pelotas Birth Cohort (Brazil): Wellcome Trust; INCAP Nutrition Trial Cohort Study (Guatemala): US National Institutes of Health; New Delhi Birth Cohort Study (India): Indian Council of Medical Research, US National Center for Health Statistics, Medical Research Council (UK), and British Heart Foundation; Cebu Longitudinal Health and Nutrition Study (Philippines): US National Institutes of Health; Birth to Twenty (South Africa): Wellcome Trust, Human Sciences Research Council, South African Medical Research Council, South-African Netherlands Programme on Alternative Development, Anglo American Chairman's Fund, and University of the Witwatersrand.; The COHORTS collaboration has received funding from the Wellcome Trust (089257/Z/09/Z).
• Keywords: BODY-MASS INDEX; FOR-GESTATIONAL-AGE; Life Sciences & Biomedicine; WEIGHT-GAIN; SUPPLEMENTATION; HEALTH; BLOOD-GLUCOSE; PRETERM; Pediatrics; COHORT PROFILE; UNDERNUTRITION; Science & Technology; SIZE
• Research Categories: Health Sciences, Public Health

Abstract

Objective To assess the impact of being born preterm or small for gestational age (SGA) on several adult outcomes. Study design We analyzed data for 4518 adult participants in 5 birth cohorts from Brazil, Guatemala, India, the Philippines, and South Africa. Results In the study population, 12.8% of males and 11.9% of females were born preterm, and 26.8% of males and 22.4% of females were born term but SGA. Adults born preterm were 1.11 cm shorter (95% CI, 0.57-1.65 cm), and those born term but SGA were 2.35 cm shorter (95% CI, 1.93-2.77 cm) compared with those born at term and appropriate size for gestational age. Blood pressure and blood glucose level did not differ by birth category. Compared with those born term and at appropriate size for gestational age, schooling attainment was 0.44 years lower (95% CI, 0.17-0.71 years) in those born preterm and 0.41 years lower (95% CI, 0.20-0.62 years) in those born term but SGA. Conclusion Being born preterm or term but SGA is associated with persistent deficits in adult height and schooling, but is not related to blood pressure or blood glucose level in low- and middle-income settings. Increased postnatal growth is associated with gains in height and schooling regardless of birth status, but not with increases in blood pressure or blood glucose level.