Effect of correcting for gestational age at birth on population prevalence of early childhood undernutrition

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorPERUMAL, Nandita
dc.contributor.authorROTH, Daniel E.
dc.contributor.authorPERDRIZET, Johnna
dc.contributor.authorBARROS, Aluisio J. D.
dc.contributor.authorSANTOS, Ina S.
dc.contributor.authorMATIJASEVICH, Alicia
dc.contributor.authorBASSANI, Diego G.
dc.date.accessioned2018-03-06T15:19:05Z
dc.date.available2018-03-06T15:19:05Z
dc.date.issued2018
dc.description.abstractBackground: Postmenstrual and/or gestational age-corrected age (CA) is required to apply child growth standards to children born preterm (< 37 weeks gestational age). Yet, CA is rarely used in epidemiologic studies in low-and middle-income countries (LMICs), which may bias population estimates of childhood undernutrition. To evaluate the effect of accounting for GA in the application of growth standards, we used GA-specific standards at birth (INTERGROWTH-21st newborn size standards) in conjunction with CA for preterm-born children in the application of World Health Organization Child Growth Standards postnatally (referred to as 'CA' strategy) versus postnatal age for all children, to estimate mean length-for-age (LAZ) and weight-for-age (WAZ) z scores at 0, 3, 12, 24, and 48-months of age in the 2004 Pelotas (Brazil) Birth Cohort. Results: At birth (n = 4066), mean LAZ was higher and the prevalence of stunting (LAZ < -2) was lower using CA versus postnatal age (mean +/- SD): -0.36 +/- 1.19 versus -0.67 +/- 1.32; and 8.3 versus 11.6%, respectively. Odds ratio (OR) and population attributable risk (PAR) of stunting due to preterm birth were attenuated and changed inferences using CA versus postnatal age at birth [OR, 95% confidence interval (CI): 1.32 (95% CI 0.95, 1.82) vs 14.7 (95% CI 11.7, 18.4); PAR 3.1 vs 42.9%]; differences in inferences persisted at 3-months. At 12, 24, and 48-months, preterm birth was associated with stunting, but ORs/PARs remained attenuated using CA compared to postnatal age. Findings were similar for weight-for-age z scores. Conclusions: Population-based epidemiologic studies in LMICs in which GA is unused or unavailable may overestimate the prevalence of early childhood undernutrition and inflate the fraction of undernutrition attributable to preterm birth.
dc.description.indexPubMed
dc.description.sponsorshipCanadian Institutes for Health Research
dc.description.sponsorshipWellcome Trust
dc.description.sponsorshipWorld Health Organization
dc.description.sponsorshipNational Support Program for Centers of Excellence (PRONEX)
dc.description.sponsorshipBrazilian National Research Council (CNPq)
dc.description.sponsorshipBrazilian Ministry of Health
dc.description.sponsorshipChildren's Pastorate
dc.identifier.citationEMERGING THEMES IN EPIDEMIOLOGY, v.15, article ID 3, 13p, 2018
dc.identifier.doi10.1186/s12982-018-0070-1
dc.identifier.issn1742-7622
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/25646
dc.language.isoeng
dc.publisherBIOMED CENTRAL LTD
dc.relation.ispartofEmerging Themes in Epidemiology
dc.rightsopenAccess
dc.rights.holderCopyright BIOMED CENTRAL LTD
dc.subjectWorld Health Organization Growth Standards (WHO-GS)
dc.subjectGestational age
dc.subjectGrowth
dc.subjectPreterm birth
dc.subjectPediatrics
dc.subjectINTERGROWTH newborn size standard
dc.subject.othermiddle-income countries
dc.subject.othergrowth standards
dc.subject.otherpreterm birth
dc.subject.otherintergrowth-21st project
dc.subject.othersystematic analysis
dc.subject.otherpostnatal-growth
dc.subject.otherfollow-up
dc.subject.otherweight
dc.subject.othermortality
dc.subject.otherchildren
dc.subject.wosPublic, Environmental & Occupational Health
dc.titleEffect of correcting for gestational age at birth on population prevalence of early childhood undernutrition
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryCanadá
hcfmusp.affiliation.countryisoca
hcfmusp.author.externalPERUMAL, Nandita:Univ Toronto, Dalla Lana Sch Publ Hlth, Dept Epidemiol, Toronto, ON, Canada; Hosp Sick Children, Child Hlth Evaluat Sci, Ctr Global Child Hlth, 686 Bay St, Toronto, ON M5G 0A4, Canada
hcfmusp.author.externalROTH, Daniel E.:Hosp Sick Children, Child Hlth Evaluat Sci, Ctr Global Child Hlth, 686 Bay St, Toronto, ON M5G 0A4, Canada; Hosp Sick Children, Div Paediat Med, Toronto, ON, Canada; Univ Toronto, Dept Paediat, Toronto, ON, Canada; Univ Toronto, Dept Nutr Sci, Toronto, ON, Canada
hcfmusp.author.externalPERDRIZET, Johnna:Univ Toronto, Dalla Lana Sch Publ Hlth, Dept Epidemiol, Toronto, ON, Canada
hcfmusp.author.externalBARROS, Aluisio J. D.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalSANTOS, Ina S.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalBASSANI, Diego G.:Univ Toronto, Dalla Lana Sch Publ Hlth, Dept Epidemiol, Toronto, ON, Canada; Hosp Sick Children, Child Hlth Evaluat Sci, Ctr Global Child Hlth, 686 Bay St, Toronto, ON M5G 0A4, Canada; Hosp Sick Children, Div Paediat Med, Toronto, ON, Canada
hcfmusp.citation.scopus9
hcfmusp.contributor.author-fmusphcALICIA MATIJASEVICH MANITTO
hcfmusp.description.articlenumber3
hcfmusp.description.volume15
hcfmusp.origemWOS
hcfmusp.origem.pubmed29441118
hcfmusp.origem.scopus2-s2.0-85041493735
hcfmusp.origem.wosWOS:000424787100002
hcfmusp.publisher.cityLONDON
hcfmusp.publisher.countryENGLAND
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