This is a prospective cohort study that will be conducted in four low income countries to describe newborn weight patterns in the first month after birth and their association with clinical and demographic factors including dietary intake.
Background: Worldwide, more than 50 million children under 5 are wasted (weight-for-length/height Z-score (WLZ) \<-2) and over 150 million children under 5 are stunted (length/height-for-age Z-score (LAZ) \<-2); such wasting and stunting often begin during infancy. Optimal early nutrition can prevent wasting and stunting. In low income countries, there is therefore a need to understand early weight patterns and how they relate to dietary intakes. Objectives: The proposed study will assess the relationship between infant dietary intake and weight change in low income countries by characterizing neonatal weight loss/gain patterns, dietary intake, and growth. Methodology: We will use a prospective cohort study design to describe early infant weight patterns and their relationship to dietary intake. Up to 880 newborns and their mothers will be enrolled in four countries: Guinea-Bissau, Nepal, Pakistan and Uganda (up to 220 newborns/site). Enrolled infants will be followed from birth until one month of age and will be assessed by anthropometry, dietary survey and hemoglobin measurement. Mothers will also be assessed for anthropometry and hemoglobin. Infants' fathers and next-oldest siblings will also be enrolled for anthropometry if available and willing to participate. Descriptive statistics will be used to describe sample characteristics. We will use various regression modeling techniques to examine the links between individual, family, and community characteristics and early infant weight patterns. Logistic regression models will also be used to consider potential confounding. Study findings will allow us to describe weight patterns in the first 30 days after birth and their relationship to the dietary intake during that time. We hypothesize that infants who lose 6% or more of their birth weight prior to beginning weight gain will have lower WAZ at 30 days of age. We also hypothesize that at 12 days of age, weight change relative to birth weight will be lower for infants born \<2500g then for infants born ≥2500g.
Study Type
OBSERVATIONAL
Enrollment
741
We will collect detailed data on dietary intake and weight for healthy newborns in four low income countries.
University of California, San Francisco
San Francisco, California, United States
International Partnership for Human Development
Bissau, Guinea-Bissau
Dhulikhel Hospital
Dhulikhel, Nepal
Aga Khan University
Karachi, Pakistan
Weight for age z-score
Weight for age z-score
Time frame: 30 days
Weight change relative to birth weight
The difference between birth weight and current weight, expressed as a proportion of birth weight
Time frame: 12 days
Weight equal to or exceeding birth weight
Infant weight equal to or exceeding birth weight
Time frame: 12 days of age
Weight nadir
Lowest weight in the first 30 days after birth, expressed as a proportion of birth weight
Time frame: 30 days
Age at weight nadir
Age in days at the time of the lowest weight in the first 30 days after birth
Time frame: 30 days
Weight for length z-score
Weight for length z-score
Time frame: 30 days
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Makerere University
Kampala, Uganda