The timing of growth faltering has important implications for observational analyses of the underlying determinants of nutrition outcomes.
The timing of growth faltering has important implications for observational analyses of the underlying determinants of nutrition outcomes.
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DOI：
10.1371/journal.pone.0195904
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Headey D
中科院分区：
文献类型：
--
作者：
Alderman H;Headey D
生长迟缓主要发生在出生后的前23个月，被认为主要是由各种有害或保护性的社会经济条件决定的。然而，23个月或更小的儿童仅部分暴露于这些条件，这意味着这些条件与儿童生长之间的统计关联在包括年幼儿童的样本中可能要小得多。检验儿童人体测量结果和各种社会经济条件之间的关联对于年龄较大和年龄较小的儿童是系统性不同的预测。我们分析了699，421名0-59个月儿童的数据，这些数据来自1992年至2014年在57个国家实施的125项DHS。结果变量为年龄别身高Z评分（HAZ）和发育迟缓（HAZ<-2），身高别体重Z评分（WHZ）和消瘦（WHZ<-2）。自变量包括家庭财富、父母教育程度、母亲身高、人口因素以及接触WASH和卫生服务的情况。我们使用按年龄分类的回归来研究因变量和自变量之间的关联在不同儿童年龄范围内的变化。非参数回归结果再次证实，大多数线性增长步履蹒跚和浪费发生在23个月大之前。从HAZ回归中估计的与财富，教育和改善厕所使用的关联程度在24-59个月的儿童样本中系统地大于0-23个月或0-59个月的样本; WHZ回归则相反。以前的观察分析似乎大大低估了保护性的影响，范围广泛的潜在的决定因素发育迟缓。相反，24-59个月的儿童的消瘦率通常较低，这意味着0-23个月的儿童的基础疾病和消瘦之间的联系可能更强。这种分析应更加关注年龄的分解;研究人员应了解当前研究中报告的年龄效应，并按年龄分层进行分析。
Growth faltering largely occurs in the first 23 months after birth and is thought to be largely determined by various harmful or protective socioeconomic conditions. Children 23 months or younger, however, have only been partially exposed to these conditions, implying that statistical associations between these conditions and child growth may be substantially smaller in samples that include younger children. To test the prediction that associations between child anthropometric outcomes and various socioeconomic conditions are systematically different for older and younger children. We analyzed data for 699,421 children aged 0–59 months, drawn from 125 DHS implemented between 1992 and 2014 in 57 countries. The outcome variables were height-for-age Z scores (HAZ) and stunting (HAZ<-2), and weight-for-height z scores (WHZ) and wasting (WHZ<-2). Independent variables included household wealth, parental education, maternal height, demographic factors, and exposure to WASH and health services. We used age-disaggregated regressions to examine how the associations between dependent and independent variables vary across different child age ranges. Non-parametric regression results reaffirmed that most linear growth faltering and wasting takes place prior to 23 months of age. Estimates of the magnitude of association with wealth, education and improved toilet use from HAZ regressions are systematically larger in the sample of children 24–59 months than in the 0–23 month or 0–59 month samples; the reverse is true for WHZ regressions. Previous observational analyses appear to substantially underestimate the protective impacts of a wide range of underlying determinants on stunting. Conversely, wasting rates are typically low for children 24–59 months, implying that associations between underlying conditions and wasting may be stronger for children 0–23 months of age. Such analyses should pay closer attention to age disaggregation; researchers should be aware of the age effect reported in the current study and present analysis stratified by age.
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与无障碍儿童相比，有改善卫生但没有改善水的儿童患有阻碍：在埃塞俄比亚，印度，秘鲁和越南进行的同类研究。
影响因子：
4.5
作者：
Dearden KA;Schott W;Crookston BT;Humphries DL;Penny ME;Behrman JR;Young Lives Determinants and Consequences of Child Growth Project Team
通讯作者：
Young Lives Determinants and Consequences of Child Growth Project Team
影响因子：
3.4
作者：
Headey D;Hoddinott J;Park S
通讯作者：
Park S
影响因子：
3.5
作者：
Filmer, D;Pritchett, LH
通讯作者：
Pritchett, LH
影响因子：
3.7
作者：
Headey DD;Hoddinott J
通讯作者：
Hoddinott J
影响因子：
4.2
作者：
Leroy, Jef L.;Ruel, Marie;Frongillo, Edward A.
通讯作者：
Frongillo, Edward A.