Publications

BACKGROUND: There is limited data in term low birth weight neonates from urban poor settings on the incidence of and recovery from undernutrition and  co-existence of its different forms, under conditions of appropriate health and  nutrition care counselling. OBJECTIVES: To determine the longitudinal growth and  undernutrition burden among term low birth weight newborns reared in adverse  conditions, but with appropriate counselling. METHODS: The study reports  follow-up data from DIVIDS trial. 2079 term low birth weight (1800-2499 grams)  newborns from an urban poor setting were followed-up for growth from 0 to 26  weeks (n=1282) and at 2.8-6.8 years (n=912). Using Cole LMS approach, age- and  sex-specific internal z scores were computed and subsequently adjusted for the  effect of a vitamin D intervention and potential bias due to attrition.  Back-transformed measurements were then used to compute WHO z scores for height  for age (HAZ), weight for age (WAZ), and BMI for age (BMIZ). RESULTS: HAZ  remained fairly stable: mean changes from birth till 6 weeks, 26 weeks and 3-7  years were 0.07, 0.04 and 0.2 SD, respectively. BMIZ and WAZ showed considerable  catch-up; 0.69 SD, 1.84 SD and 1.38 SD for BMIZ, and 0.25 SD, 0.89 SD and 0.60 SD  for WAZ, respectively. 60-92% had at least one form of undernutrition and  co-existence was frequent. Half the children remained stunted till 5 years, while  underweight and wasting declined considerably from 0-6 months. CONCLUSION: With  appropriate counselling of parents, term low birth weight infants reared under  adverse socioeconomic conditions show substantial catch-up growth in BMIZ and WAZ  but not in HAZ. The long-term consequences of this excess weight over length gain  need focused evaluation.