Catch-up growth in height and cognitive function: Why definitions matter
Catch-up growth in height and cognitive function: Why definitions matter
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DOI：
10.1016/j.ehb.2020.100853
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发表时间：
2020-05-01
影响因子：
2.5
通讯作者：
Richter, Linda M.
中科院分区：
文献类型：
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作者：
Casale, Daniela;Desmond, Chris;Richter, Linda M.
有大量证据表明，以发育迟缓为标志的早期生长迟缓与儿童认知功能较差有关。然而，对于发育迟缓儿童随后的“追赶”生长与类似的“追赶”认知功能的关联程度，存在相互矛盾的发现。在本文中，我们表明文献中明显的矛盾可能是由于不同研究中使用的赶超定义不同所致。我们探讨了定义的两种变化：衡量追赶性生长的年龄，以及归类为“追赶性”所需的生长程度。使用来自南非的队列数据，对幼儿时期的身长进行重复测量，我们首先表明，将追赶的起始年龄从 1 岁改为 2 岁，会极大地影响关于认知结果的结论，因为发育迟缓的患病率往往在 2 岁左右达到峰值。其次，我们展示了当我们改变追赶的标准时，结果有何不同，在这里我们探讨了从最宽松到最严格的五个定义。最严格的定义要求孩子们已经足够赶上，以便他们的年龄别身高在随访时落在“正常”范围内；很少有孩子能赶上这个程度。对于所有追赶的定义，除了最严格的定义外，我们发现 2 岁时发育迟缓的儿童随后经历追赶性生长，平均而言，在认知测试中比从未发育迟缓的儿童表现更差，并且几乎与仍然发育迟缓的儿童一样差（系数范围为 -1.584；p
There is substantial evidence that early growth retardation, indicated by stunting, is associated with poorer cognitive function among children. There are, however, contradictory findings on the extent to which subsequent 'catch-up' growth among stunted children is associated with similar 'catch-up' cognitive functioning. In this paper we show that the apparent contradictions in the literature may be a result of differences in the definition of catch up used in the different studies. We explore two variations in definition: the age from which catch-up growth is measured, and the extent of growth required to be classified as 'caught up'. Using cohort data from South Africa with repeated measures of length in early childhood, we first show that varying the starting age from which catch up is measured from 1y to 2y greatly affects the conclusions drawn with respect to cognitive outcomes, as the prevalence of stunting tends to peak around 2y. Second, we show how the results differ when we vary what counts as catch up, and here we explore five definitions ranging from most lenient to strictest. The strictest definition requires children to have caught up sufficiently that their height-for-age falls within the 'normal' range at follow-up; very few children catch up to this extent. For all definitions of catch-up, except the strictest, we find that children who are stunted at 2 years of age who subsequently experience catch-up growth, on average, do worse on cognitive tests than children who were never stunted, and almost as poorly as children who remain stunted (with the coefficient ranging from -1.584; p