Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity

Background: Relations between size and maturity at birth and infant growth have been studied inadequately in Bangladesh where the incidence of Low bir th weight is high and most infants are breast-fed. Objective: This study was conducted to describe infant growth patterns and their relations to birth weight, intrauterine growth retardation, and prema turity. Design: A total of 1654 infants born in selected low-socioeconomic areas uf Dhaka, Bangladesh, were enrolled at birth. Weight and length were measured at birth and at 1, 3, 6, 9, and 12 mo of age. Results: The infants' mean birth weight was 2516 g, with 46.4% weighing < 2 590 g; 70% were small for gestational age (SGA) and 17% were premature. Amo ng the SGA infants, 63% had adequate ponderal indexes. The mean weight of t he study infants closely tracked the -2 SD curve of the World Health Organi zation pooled breast-fed sample. Weight differences by birth weight, SGA, o r preterm categories were retained throughout infancy. Mean z scores based on the pooled breast-fed sample were -2.38, -1.72, and -2.34 at birth, 3 mo , and 12 mo. Correlation analysis showed greater plasticity of growth in th e first 3 mo of life than later in the first year. Conclusions: Infant growth rates were similar to those observed among breas t-fed infants in developed countries. Most study infants experienced chroni c intrauterine undernourishment. Catch-up growth was limited and weight at 12 mo was largely a function of weight at birth. Improvement of birth weigh t is likely to lead to significant gains in infant nutritional status in th is population, although interventions in the first 3 mo are also likely to be beneficial.