Celia Rodd1, Allison Feely2, Allan B Becker1,3, Theo J Moraes4, Padmaja Subbarao4, Piushkumar J Mandhane5, Stuart E Turvey6, Diana L Lefebvre7, Malcolm R Sears7, Meghan B Azad1,3, Atul Sharma1. 1. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba. 2. George and Fay Yee Centre for Health Care Innovation, University of Manitoba, Winnipeg, Manitoba. 3. Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba. 4. Departments of Pediatrics, University of Toronto, Toronto, Ontario. 5. Department Pediatrics, University of Alberta, Edmonton, Alberta. 6. Department of Pediatrics, University of British Columbia, Vancouver, British Columbia. 7. Department of Medicine, McMaster University, Hamilton, Ontario.
Abstract
BACKGROUND: World Health Organization (WHO) growth standards for children aged 0 to 5 years describe growth under optimal conditions and were adopted for use in Canada in 2012. We are seeking to validate these charts in a well-characterized, longitudinal cohort of healthy, Canadian youngsters, assess tracking over time, and evaluate the prognostic implications of early growth. METHODS: Data from 2,795 mother-infant dyads from the CHILD birth cohort were classified by feeding modality at 6 months as exclusively breastfed, partially breastfed, or formula-fed. WHO z-scores (z) were calculated at birth, 3 months, 1 year, and 3 years. Receiver operator characteristics (ROC) assessed the predictive performance of early weight (WT), weight-for-length (WfL), or body mass index (BMI) z-scores for overweight/obesity at 3 years. RESULTS: Compared to WHO standards, Canadian children at birth had lower median WfLz (-0.73) and BMIz (-0.29), with more positive scores by 3 years (WfLz=BMIz=0.58). At both 1 and 3 years, formula feeding was associated with higher scores than breastfeeding, even after regression adjustment for covariates. Head circumference z-score was typically positive at all times and regardless of feeding modality. At 1 year, ROC area under the curve was 0.79 for WTz, WfLz, and BMIz, and BMIz>0.88 identified children with increased risk of overweight/obesity (BMIz >2) at age 3 years (20.3% versus 3.0%, P<0.001). CONCLUSIONS: Compared to WHO growth charts, Canadian children at 3 years show an upward shift in BMIz and WfLz, particularly when formula-fed. Infant growth parameters may identify infants with increased risk of overweight/obesity at age 3 years; early recognition may allow targeting infants at higher risk.
BACKGROUND: World Health Organization (WHO) growth standards for children aged 0 to 5 years describe growth under optimal conditions and were adopted for use in Canada in 2012. We are seeking to validate these charts in a well-characterized, longitudinal cohort of healthy, Canadian youngsters, assess tracking over time, and evaluate the prognostic implications of early growth. METHODS: Data from 2,795 mother-infant dyads from the CHILD birth cohort were classified by feeding modality at 6 months as exclusively breastfed, partially breastfed, or formula-fed. WHO z-scores (z) were calculated at birth, 3 months, 1 year, and 3 years. Receiver operator characteristics (ROC) assessed the predictive performance of early weight (WT), weight-for-length (WfL), or body mass index (BMI) z-scores for overweight/obesity at 3 years. RESULTS: Compared to WHO standards, Canadian children at birth had lower median WfLz (-0.73) and BMIz (-0.29), with more positive scores by 3 years (WfLz=BMIz=0.58). At both 1 and 3 years, formula feeding was associated with higher scores than breastfeeding, even after regression adjustment for covariates. Head circumference z-score was typically positive at all times and regardless of feeding modality. At 1 year, ROC area under the curve was 0.79 for WTz, WfLz, and BMIz, and BMIz>0.88 identified children with increased risk of overweight/obesity (BMIz >2) at age 3 years (20.3% versus 3.0%, P<0.001). CONCLUSIONS: Compared to WHO growth charts, Canadian children at 3 years show an upward shift in BMIz and WfLz, particularly when formula-fed. Infant growth parameters may identify infants with increased risk of overweight/obesity at age 3 years; early recognition may allow targeting infants at higher risk.
Authors: Jennifer S Savage; Leann L Birch; Michele Marini; Stephanie Anzman-Frasca; Ian M Paul Journal: JAMA Pediatr Date: 2016-08-01 Impact factor: 16.193
Authors: Meghan B Azad; Atul K Sharma; Russell J de Souza; Vernon W Dolinsky; Allan B Becker; Piushkumar J Mandhane; Stuart E Turvey; Padmaja Subbarao; Diana L Lefebvre; Malcolm R Sears Journal: JAMA Pediatr Date: 2016-07-01 Impact factor: 16.193
Authors: Michael S Kramer; Tong Guo; Robert W Platt; Stanley Shapiro; Jean-Paul Collet; Beverley Chalmers; Ellen Hodnett; Zinaida Sevkovskaya; Irina Dzikovich; Irina Vanilovich Journal: Pediatrics Date: 2002-08 Impact factor: 7.124