Determination of modifiable risk factors for length-for-age z-scores among resource-poor Indonesian infants.

Autor: Diana A; Faculty of Medicine, Nutrition Working Group, Universitas Padjadjaran, Bandung, Indonesia.; Department of Human Nutrition, University of Otago, Dunedin, New Zealand., Haszard JJ; Department of Human Nutrition, University of Otago, Dunedin, New Zealand., Sari SYI; Faculty of Medicine, Department of Public Health, Universitas Padjadjaran, Bandung, Indonesia., Rahmannia S; Faculty of Medicine, Universitas Pasundan, Bandung, Indonesia., Fathonah A; Faculty of Medicine, Nutrition Working Group, Universitas Padjadjaran, Bandung, Indonesia., Sofiah WN; Faculty of Medicine, Nutrition Working Group, Universitas Padjadjaran, Bandung, Indonesia., Rizqi H; Faculty of Medicine, Nutrition Working Group, Universitas Padjadjaran, Bandung, Indonesia., Haekal R; Faculty of Medicine, Nutrition Working Group, Universitas Padjadjaran, Bandung, Indonesia., Gilmartin A; Department of Microbiology, Immunology and Cancer Biology, University of Virginia, Charlottesville, Virginia, United States of America., Harper M; Department of Human Nutrition, University of Otago, Dunedin, New Zealand., Petri W; Department of Microbiology, Immunology and Cancer Biology, University of Virginia, Charlottesville, Virginia, United States of America., Houghton L; Department of Human Nutrition, University of Otago, Dunedin, New Zealand., Gibson R; Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Feb 18; Vol. 16 (2), pp. e0247247. Date of Electronic Publication: 2021 Feb 18 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0247247
Abstrakt: To reduce the burden of early-life linear growth faltering in low- and middle-income countries, interventions have focused on nutrition strategies, sometimes combined with water quality, sanitation, and hygiene (WASH). However, even when combined, their effects on linear growth have been inconsistent. Here, we investigate potential predictors of length-for-age z-scores (LAZ) in a cohort of resource-poor rural Indonesian infants to inform the optimal strategies to reduce linear growth faltering. Apparently healthy rural breastfed Indonesian infants were randomly selected from birth registries at age 6 months (n = 230) and followed up at 9 (n = 202) and 12 (n = 190) months. Using maximum likelihood estimation, we examined longitudinal relationships among socio-demographic status, maternal height, infant sex, age, water source, sanitation facility, energy, protein, micronutrient intakes and biomarkers (serum ferritin, zinc, retinol binding protein (RBP), selenium-adjusted for inflammation), and α-1-acid glycoprotein (AGP) and C-reactive protein (CRP) (systemic inflammation biomarkers) at age 6 and 9 months on LAZ at age 9 and 12 months. Stunting (LAZ <-2) at 6, 9, and 12 months was 15.7%, 19.3%, and 22.6%, respectively. In the full model, the predictor variable at age 6 months that was most strongly associated with infant LAZ at 9 months was maternal height (0.18 (95% CI 0.03, 0.32) SD). At age 9 months, the strongest predictors of LAZ at 12 months were improved drinking water source (-0.40 (95% CI -0.65, -0.14) vs. not improved), elevated AGP compared to not elevated (0.26 (95%CI -0.06, 0.58), maternal height (0.16 (95% CI 0.02, 0.31) SD), sex (0.22 (95% CI -0.02,0.45) female vs. male), serum RBP (0.12 (95% CI -0.01, 0.25) SD), and protein intake (0.17 (95% CI -0.01, 0.35) SD). Health promotion that includes exclusive breastfeeding up to the first six months and follows microbial water quality guidelines to ensure water intake is always safe should be considered.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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