Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity(abstracts)

Abstract

Objective: Describe the patterns of growth in body weight among infants till their first birthday, especially with reference to birth weight, intrauterine growth retardation (IUGR), and prematurity Methodology: One thousand six hundred fifty-four infants, born in selected slum areas of Dhaka, were enrolled at birth and followed longitudinally till they reached 12 months of age. Weights, lengths, and baseline information of these infants were measured at enrollment. Anthropometric measurements were taken again at 1, 3, 6, 9 and 12 months of age. Analysis was limited to descriptive statistics based on means and proportions, and comparisons to growth references. Results: The mean birth weight of the infants was 2,517 £, and 46-6^ had low (<2,5OO g) birth weight (LBW). Sixty-nine percent were bom with IUGR, and 17% were premature. Of the growth-retarded newboms, birth weights of 63% of the infants were proportionate to their lengths according to the ponderal index. This indicates that most IUGR infants were subjected to chronic intrauterine undernourishment. The growth of the infants in the study sample was similar to that of a pooled sample of breastfed infants from affluent countries, in that the study infants closely tracked the -2 SD curve of the "reference" infants. The mean z-scores (based on the breastfed reference) were very similar at birth and 12 months (-2.38 and -2.34) and only showed slight improvements in the first 3 months (-1.72). Differences in weight at birth between infants grouped according to birth weight, IUGR and/or prematurity status were retained throughout infancy. Conclusion: The infant growth rate in this sample was similar to that observed amongst the breastfed infants in developed countries. Catch-up growth was not seen, and weight at 12 months was largely a function of weight at birth. The data suggest the need to focus on the improvement of birth weight as the principal means for improving nutritional status of infants in this population.