Associations of growth trajectories in infancy and early childhood with later childhood outcomes

Kate Tilling*, Neil M. Davies, Emily J Agnew, Yoav Ben-Shlomo, Michael S. Kramer, Rita Patel, Emily Oken, Richard M. Martin

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

36 Citations (Scopus)


Background: Weight and length at birth (which represent fetal growth) and weight and length or height gain during childhood (which potentially represent catch-up growth) may be related to later health outcomes. However, methods for the assessment of such relations are complex and underdeveloped.

Objectives: We aimed to describe childhood weight and length or height trajectories and to relate these to later outcomes by using rash at age 6.5 y as an example.

Design: The data came from a prospective cohort study in Belarus in 10,494 children born in 31 hospitals that participated in a cluster randomized trial of breastfeeding promotion. Weight and length or height were measured at birth, at scheduled clinic visits up to 1 y, and at 6.5 y; intermediate measures were obtained from routine child health records. Linear spline multilevel models for weight and length or height were used to estimate each child's deviance from average birth weight, birth length, weight, and length or height gain velocity in each time period. Logistic regression was used to relate the outcome (parental report of rash at 6.5 y) to these weight and length or height estimates.

Results: The best-fitting splines for length or height and weight had knots at 3 and 12 mo, with another knot at 34 mo for height. The only relation between weight and length or height and reported rash was a positive association with weight gain velocity between 12 and 34 mo (odds ratio per SD increase in weight gain velocity: 1.11; 95% CI: 1.01, 1.22).

Conclusion: Advantages of multilevel models include no restriction to measures at arbitrary times or to individuals with complete data and allowance for measurement error. This trial was registered at as ISRCTN37687716. Am J Clin Nutr 2011;94(suppl):1808S-13S.

Original languageEnglish
Pages (from-to)1808S-1813S
Number of pages6
JournalAmerican Journal of Clinical Nutrition
Issue number6
Publication statusPublished - Dec 2011
EventInternational Conference on The Power of Programming - Developmental Origins of Health and Disease - Munich, Germany
Duration: 6 May 20108 May 2010


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