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Obstetrics - Pediatrics and Child Health - Public Health and Epidemiology


Factors Associated with Height Catch-Up and Catch-Down Growth Among Schoolchildren
Published: Monday, March 12, 2012
Author: Rosângela F. L. Batista et al.

by Rosângela F. L. Batista, Antônio A. M. Silva, Marco A. Barbieri, Vanda M. F. Simões, Heloisa Bettiol

In developed countries, children with intrauterine growth restriction (IUGR) or born preterm (PT) tend to achieve catch-up growth. There is little information about height catch-up in developing countries and about height catch-down in both developed and developing countries. We studied the effect of IUGR and PT birth on height catch-up and catch-down growth of children from two cohorts of liveborn singletons. Data from 1,463 children was collected at birth and at school age in Ribeirão Preto (RP), a more developed city, and in São Luís (SL), a less developed city. A change in z-score between schoolchild height z-score and birth length z-score=0.67 was considered catch-up; a change in z-score=-0.67 indicated catch-down growth. The explanatory variables were: appropriate weight for gestational age/PT birth in four categories: term children without IUGR (normal), IUGR only (term with IUGR), PT only (preterm without IUGR) and preterm with IUGR; infant's sex; maternal parity, age, schooling and marital status; occupation of family head; family income and neonatal ponderal index (PI). The risk ratio for catch-up and catch-down was estimated by multinomial logistic regression for each city. In RP, preterms without IUGR (RR?=?4.13) and thin children (PI<10th percentile, RR?=?14.39) had a higher risk of catch-down; catch-up was higher among terms with IUGR (RR?=?5.53), preterms with IUGR (RR?=?5.36) and children born to primiparous mothers (RR?=?1.83). In SL, catch-down was higher among preterms without IUGR (RR?=?5.19), girls (RR?=?1.52) and children from low-income families (RR?=?2.74); the lowest risk of catch-down (RR?=?0.27) and the highest risk of catch-up (RR?=?3.77) were observed among terms with IUGR. In both cities, terms with IUGR presented height catch-up growth whereas preterms with IUGR only had height catch-up growth in the more affluent setting. Preterms without IUGR presented height catch-down growth, suggesting that a better socioeconomic situation facilitates height catch-up and prevents height catch-down growth.
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