Growth dynamics of Indian infants using latent trajectory models in pooled survey datasets

BackgroundNational survey data show that age- and sex-standardized weight and length measurements decline early in Indian children. In population-level longitudinal data, early detection of growth trajectories is important for the implementation of interventions. We aimed to identify and characteriz...

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Main Authors: Aswathi Saji, Jeswin Baby, Prem Antony, Srishti Sinha, Sulagna Bandyopadhyay, Joby K. Jose, Anura V. Kurpad, Tinku Thomas
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1474222/full
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author Aswathi Saji
Jeswin Baby
Jeswin Baby
Prem Antony
Srishti Sinha
Sulagna Bandyopadhyay
Joby K. Jose
Anura V. Kurpad
Tinku Thomas
author_facet Aswathi Saji
Jeswin Baby
Jeswin Baby
Prem Antony
Srishti Sinha
Sulagna Bandyopadhyay
Joby K. Jose
Anura V. Kurpad
Tinku Thomas
author_sort Aswathi Saji
collection DOAJ
description BackgroundNational survey data show that age- and sex-standardized weight and length measurements decline early in Indian children. In population-level longitudinal data, early detection of growth trajectories is important for the implementation of interventions. We aimed to identify and characterize distinct growth trajectories of Indian children from birth to 12 months of age residing in urban and rural areas.MethodsPooled data from four interventional and non-interventional longitudinal studies across India were used for the analysis. Latent class mixed modeling (LCMM) was employed to identify groups of children with similar trajectories over age. The trajectories named Classes of Children were created for length-for-age Z scores (LAZ) and weight-for-age Z scores (WAZ) based on place of birth, residential area, and maternal education.ResultsWe identified two latent classes for LAZ in boys and three latent classes for LAZ in girls, and four classes for WAZ were identified in both boys and girls. The first class for LAZ, with the highest proportion of children (>80% of children), did not decline or increase with age; In boys, Class 1 was close to the WHO median, whereas in girls, Class 1 was lower than the WHO median from birth. The LAZ classes of remaining boys and girls declined with age (slope, μdg= − 1.04; 95% CI: −1.09, −0.99 for boys and μdg= − 0.69; 95% CI: −0.76, −0.63 for girls). The first trajectory of WAZ (approximately 50% of children) for boys (μdg=0.13; 95% CI: 0.11, 0.16) and the second trajectory of WAZ for girls (μdg=0.24; 95% CI: 0.18, 0.30) increased with age, while the remaining trajectories of WAZ declined with age.ConclusionThere is heterogeneity in the growth of Indian children in the first year of life, which was identified by distinct types of growth trajectories. The predominant trajectories of both LAZ and WAZ did not decline with age, while most other trajectories demonstrated an initial decline.
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spelling doaj-art-c2f6466f4b6b4196b994afe951d33a032025-01-07T06:48:39ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.14742221474222Growth dynamics of Indian infants using latent trajectory models in pooled survey datasetsAswathi Saji0Jeswin Baby1Jeswin Baby2Prem Antony3Srishti Sinha4Sulagna Bandyopadhyay5Joby K. Jose6Anura V. Kurpad7Tinku Thomas8Division of Epidemiology and Biostatistics, St. John’s Research Institute, Bangalore, IndiaDivision of Epidemiology and Biostatistics, St. John’s Research Institute, Bangalore, IndiaDepartment of Statistical Sciences, Kannur University, Kannur, Kerala, IndiaDivision of Epidemiology and Biostatistics, St. John’s Research Institute, Bangalore, IndiaDivision of Nutrition, St. John’s Research Institute, Bangalore, IndiaDivision of Nutrition, St. John’s Research Institute, Bangalore, IndiaDepartment of Statistical Sciences, Kannur University, Kannur, Kerala, IndiaDepartment of Physiology, St. John’s Medical College, Bangalore, IndiaDepartment of Biostatistics, St. John’s Medical College, Bangalore, IndiaBackgroundNational survey data show that age- and sex-standardized weight and length measurements decline early in Indian children. In population-level longitudinal data, early detection of growth trajectories is important for the implementation of interventions. We aimed to identify and characterize distinct growth trajectories of Indian children from birth to 12 months of age residing in urban and rural areas.MethodsPooled data from four interventional and non-interventional longitudinal studies across India were used for the analysis. Latent class mixed modeling (LCMM) was employed to identify groups of children with similar trajectories over age. The trajectories named Classes of Children were created for length-for-age Z scores (LAZ) and weight-for-age Z scores (WAZ) based on place of birth, residential area, and maternal education.ResultsWe identified two latent classes for LAZ in boys and three latent classes for LAZ in girls, and four classes for WAZ were identified in both boys and girls. The first class for LAZ, with the highest proportion of children (>80% of children), did not decline or increase with age; In boys, Class 1 was close to the WHO median, whereas in girls, Class 1 was lower than the WHO median from birth. The LAZ classes of remaining boys and girls declined with age (slope, μdg= − 1.04; 95% CI: −1.09, −0.99 for boys and μdg= − 0.69; 95% CI: −0.76, −0.63 for girls). The first trajectory of WAZ (approximately 50% of children) for boys (μdg=0.13; 95% CI: 0.11, 0.16) and the second trajectory of WAZ for girls (μdg=0.24; 95% CI: 0.18, 0.30) increased with age, while the remaining trajectories of WAZ declined with age.ConclusionThere is heterogeneity in the growth of Indian children in the first year of life, which was identified by distinct types of growth trajectories. The predominant trajectories of both LAZ and WAZ did not decline with age, while most other trajectories demonstrated an initial decline.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1474222/fullgrowth trajectorylength-for-age Z scoreweight-for-age Z scorelongitudinal datainfants
spellingShingle Aswathi Saji
Jeswin Baby
Jeswin Baby
Prem Antony
Srishti Sinha
Sulagna Bandyopadhyay
Joby K. Jose
Anura V. Kurpad
Tinku Thomas
Growth dynamics of Indian infants using latent trajectory models in pooled survey datasets
Frontiers in Public Health
growth trajectory
length-for-age Z score
weight-for-age Z score
longitudinal data
infants
title Growth dynamics of Indian infants using latent trajectory models in pooled survey datasets
title_full Growth dynamics of Indian infants using latent trajectory models in pooled survey datasets
title_fullStr Growth dynamics of Indian infants using latent trajectory models in pooled survey datasets
title_full_unstemmed Growth dynamics of Indian infants using latent trajectory models in pooled survey datasets
title_short Growth dynamics of Indian infants using latent trajectory models in pooled survey datasets
title_sort growth dynamics of indian infants using latent trajectory models in pooled survey datasets
topic growth trajectory
length-for-age Z score
weight-for-age Z score
longitudinal data
infants
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1474222/full
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