DO MODIFIABLE HOUSEHOLD BEHAVIORS AND EARLY INFANT FEEDING PRACTICES CONTRIBUTE TO VARIATIONS IN INFANT LINEAR GROWTH? EVIDENCE FROM A BIRTH COHORT IN DHAKA, BANGLADESH
Notice bibliographique
Résumé
Abstract BACKGROUND Numerous postnatal risk factors have been associated with child length/height in cross-sectional studies in low- and middle-income countries. However, there have been few longitudinal studies of the effects of modifiable risk factors on postnatal linear growth during discrete developmental windows of infancy. OBJECTIVES We aimed to assess associations between modifiable household behaviours and conditional growth from birth to 1 year of life. DESIGN/METHODS We conducted a longitudinal cohort study using data from women and their infants (n=1162 pairs) in the Maternal Vitamin D and Infant Growth trial in Dhaka, Bangladesh. Infant length was measured tri-monthly from birth to 12 months, and infant feeding patterns were ascertained at weekly visits from 0 to 6 months of age. Confounder-adjusted associations of selected modifiable household factors (i.e., household air quality, sanitation/hygiene) or early infant feeding with change in length-for-age z-score (LAZ) were estimated in five intervals: birth to 3 months, 3 to 6 months, birth to 6 months, 6 to 12 months and birth to 12 months. In primary analyses, the outcome was conditional growth in LAZ (cLAZ) in each interval, derived as model residuals from regression of end-interval LAZ on initial LAZ. Effect estimates were expressed as mean difference in cLAZ (95% confidence interval) between the exposed versus referent group. RESULTS LAZ was symmetrically distributed, with mean (± standard deviation) LAZ of -0.95 (± 1.02) at birth and -1.00 (± 1.04) at 12 months. In multivariable-adjusted linear regression models, indicators of household air quality and sanitation/hygiene were not significantly associated with cLAZ in any interval. No breastfeeding and partial breastfeeding (versus exclusive breastfeeding), and any infant formula use (versus no formula use) were associated with slower growth in the 0–3 month interval: -0.11 (95% CI: -0.20, -0.02), -0.30 (95% CI: -0.52, -0.08), and -0.13 (95% CI: -0.22, -0.05), respectively, but not in later intervals. Several non-modifiable factors (maternal height, paternal education, and household wealth) were associated with cLAZ and LAZ in multivariable models. CONCLUSION Compared to international standards, the length distribution of infants in Dhaka, Bangladesh was harmonically shifted down at birth and throughout the first year of life, suggesting that observed infant length deficits relative to international norms were primarily caused by ubiquitous factors. Infant feeding practices explained some between-child variation in linear growth in the early postnatal period (0–3 months). Behaviors related to cooking or sanitation/hygiene were not related to infant linear growth trajectories.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».