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Longitudinal Growth and Undernutrition Burden Among Term Low Birth Weight Newborns Reared in Adverse Socioeconomic Conditions in Delhi

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Abstract

Background

There is limited data in term low birth weight neonates from urban poor settings on the incidence of and recovery from undernutrition and co-existence of its different forms, under conditions of appropriate health and nutrition care counselling.

Objectives

To determine the longitudinal growth and undernutrition burden among term low birth weight newborns reared in adverse conditions, but with appropriate counselling.

Methods

The study reports follow-up data from DIVIDS trial. 2079 term low birth weight (1800–2499 grams) newborns from an urban poor setting were followed-up for growth from 0 to 26 weeks (n=1282) and at 2.8–6.8 years (n=912). Using Cole LMS approach, age- and sex-specific internal z scores were computed and subsequently adjusted for the effect of a vitamin D intervention and potential bias due to attrition. Back-transformed measurements were then used to compute WHO z scores for height for age (HAZ), weight for age (WAZ), and BMI for age (BMIZ).

Results

HAZ remained fairly stable: mean changes from birth till 6 weeks, 26 weeks and 3–7 years were 0.07, 0.04 and 0.2 SD, respectively. BMIZ and WAZ showed considerable catch-up; 0.69 SD, 1.84 SD and 1.38 SD for BMIZ, and 0.25 SD, 0.89 SD and 0.60 SD for WAZ, respectively. 60–92% had at least one form of undernutrition and co-existence was frequent. Half the children remained stunted till 5 years, while underweight and wasting declined considerably from 0–6 months.

Conclusion

With appropriate counselling of parents, term low birth weight infants reared under adverse socioeconomic conditions show substantial catch-up growth in BMIZ and WAZ but not in HAZ. The long-term consequences of this excess weight over length gain need focused evaluation.

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Funding

Funding: The two phases of the DIVIDS study were funded by the Department of Biotechnology, Ministry of Science and Technology, Government of India; Nutrition Third World; and Sight and Life. None of the funding sources was involved in any aspect of the study design, conduct, analysis, or interpretation.

Author information

Authors and Affiliations

  1. Global Clinical Development Statistics and Data Management, Veterinary Medicine Research and Development, Zoetis, Zaventem, Belgium

    Manpreet Kaur

  2. Delhi School of Public Health, Delhi University, Delhi, India

    Geeta Trilok-Kumar

  3. Division of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India, B-16 Qutab Institutional Area, 110 016

    Sikha Sinha & Harshpal Singh Sachdev

  4. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

    Suzanne Filteau

  5. Department of Physiology, St John’s Medical College, Bengaluru, Karnataka, India

    Anura V. Kurpad

  6. Biostatistics, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    Clive Osmond

Authors
  1. Manpreet Kaur
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  2. Geeta Trilok-Kumar
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  3. Sikha Sinha
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  4. Suzanne Filteau
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  5. Anura V. Kurpad
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  6. Clive Osmond
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  7. Harshpal Singh Sachdev
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Contributions

Contributors: The DIVIDS Cohort study was designed and initiated by GTK (Principal Investigator), HSS (Co-Investigator), and SF (Co-Investigator), and was supervised by GTK; HSS: conceptualized the research question in this manuscript; MK: was involved in data collection; SS: did the primary analyses and interpretation under the supervision of CO and HSS. MK, HSS: drafted the initial manuscript. All authors provided critical inputs into revision of the article and approved the finalized draft and are willing to be accountable for all aspects of the study.

Corresponding author

Correspondence to Harshpal Singh Sachdev.

Ethics declarations

Ethics clearance: The DIVIDS-1 study and the DIVIDS-2 study were approved by ethics committees of the participating institutions. Authors declare that the study procedures conform to the principles laid down in the Declaration of Helsinki.

Competing interests: None stated.

Additional information

Note: Additional material related to this study is available with the online version at www.indianpediatrics.net

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Kaur, M., Trilok-Kumar, G., Sinha, S. et al. Longitudinal Growth and Undernutrition Burden Among Term Low Birth Weight Newborns Reared in Adverse Socioeconomic Conditions in Delhi. Indian Pediatr 60, 899–907 (2023). https://doi.org/10.1007/s13312-023-3033-8

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  • DOI: https://doi.org/10.1007/s13312-023-3033-8

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