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J Pediatr. 2016 Nov;178:40-46.e3. doi: 10.1016/j.jpeds.2016.06.017. Epub 2016 Jul 21.

Maternal Prenatal Nutrition and Birth Outcomes on Malnutrition among 7- to 10-Year-Old Children: A 10-Year Follow-Up.

Author information

1
Department of Epidemiology and Biostatistics, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
2
Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
3
Department of Epidemiology and Biostatistics, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China; Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi, China. Electronic address: xjtu_yh.paper@aliyun.com.

Abstract

OBJECTIVES:

To identify postnatal predictors of malnutrition among 7- to 10-year-old children and to assess the long-term effects of antenatal micronutrient supplementation on malnutrition.

STUDY DESIGN:

A follow-up study was conducted to assess the nutritional status of 7- to 10-year-olds (1747 children) whose mothers participated in a cluster-randomized double-blind controlled trial from 2002 to 2006.

RESULTS:

The rate of malnourished 7- to 10-year-olds was 11.1%. A mixed-effects logistic regression model adjusted for the cluster-sampling design indicated that mothers with low prepregnant midupper arm circumference had boys with an increased risk of thinness (aOR  2.05, 95% CI  1.11, 3.79) and girls who were more likely to be underweight (aOR 2.01, 95% CI 1.05, 3.85). Antenatal micronutrient supplementation was not significantly associated with malnutrition. Low birth weight was significantly associated with increased odds of malnutrition among boys (aOR 4.34, 95% CI 1.82, 10.39) and girls (aOR  7.50, 95% CI 3.48, 16.13). Being small for gestational age significantly increased the odds of malnutrition among boys (aOR 1.75, 95% CI 1.01, 3.04) and girls (aOR 4.20, 95% CI  2.39, 7.39). In addition, household wealth, parental height, being picky eater, and illness frequency also predicted malnutrition.

CONCLUSIONS:

Both maternal prenatal nutrition and adverse birth outcomes are strong predictors of malnutrition among early school-aged children. Currently, available evidence is insufficient to support long-term effects of antenatal micronutrient supplementation on children's nutrition.

TRIAL REGISTRATION:

www.isrctn.com: ISRCTN08850194.

KEYWORDS:

adverse birth outcomes; child malnutrition; early school-aged; follow-up study; maternal prenatal nutrition

PMID:
27449363
DOI:
10.1016/j.jpeds.2016.06.017
[Indexed for MEDLINE]
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