Publications

BACKGROUND: National 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. METHODS: Pooled 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. RESULTS: We  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. CONCLUSION: There 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.