Maternal and environmental risk for faltered growth in the first 5 years for Tanjungsari children in West Java, Indonesia

Asia Pac J Clin Nutr. 2019;28(Suppl 1):S32-S42. doi: 10.6133/apjcn.201901_28(S1).0003.

Abstract

Background and objectives: Low birth weight leads to growth faltering, attributable inter alia to malnutrition and maternal health and literacy. Risk for growth faltering in rural children under five is studied.

Study design: The Risk Approach Strategy in Tanjungsari, West Java has been analysed for all pregnancies during 1988-1989 and 4,698 singleton infants born between 1 January 1988 and 31 April 1990. Weight and body length/height measurements were repeated over 60 months, and plotted against WHO standards. Weight-for-age and height-forage z-scores were calculated using 2006 WHO growth as reference. The correlation between shortness (so-called stunting) and its presumptive risk factors was determined. A subset underwent DNA analysis for insulin-like growth factor-1 (IGF-1), and insulin receptor substrate-1 (IRS-1) polymorphism.

Results: Weight and body length/height follow-ups were followed-up for 3795 infants; 14.2% of the cohort had low birth weight (<2500 g) (LBW) and 85.8% normal birth weight (NBW). LBW infants showed a similar velocity but tended to catch up more slowly (GEE; p<0.001). Relative to WHO references, the differential for stature increased with age, largely offset by reduced weight-for-age so that weight-for-height tracked close to the WHO reference; this contrasts with more divergence internationally. Birth length and weight, along with potable water access were correlated with stunting for children under 2 years. Neither the observed IGF-1, IRS-1 or combined gene polymorphisms were associated with LBW.

Conclusions: The prediction by factors operative during pregnancy for early life stature, with some adaptation for LBW infants, endures to 60 months.

MeSH terms

  • Adolescent
  • Adult
  • Birth Weight
  • Body Height
  • Body Weight
  • Child, Preschool
  • Female
  • Growth Disorders / diagnosis*
  • Growth Disorders / epidemiology
  • Growth Disorders / physiopathology
  • Humans
  • Indonesia / epidemiology
  • Infant
  • Infant, Low Birth Weight / growth & development*
  • Infant, Newborn
  • Insulin-Like Growth Factor I / genetics
  • Longitudinal Studies
  • Male
  • Polymorphism, Genetic
  • Pregnancy
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Young Adult

Substances

  • Insulin-Like Growth Factor I