Cargando…

Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes

Child growth standards are commonly used to derive age- and sex-standardized anthropometric indices but are often inappropriately applied to preterm-born children (<37 weeks of gestational age (GA)) in epidemiology studies. Using the 2004 Pelotas Birth Cohort, we examined the impact of correcting...

Descripción completa

Detalles Bibliográficos
Autores principales: Perumal, Nandita, Roth, Daniel E, Cole, Donald C, Zlotkin, Stanley H, Perdrizet, Johnna, Barros, Aluisio J D, Santos, Ina S, Matijasevich, Alicia, Bassani, Diego G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936033/
https://www.ncbi.nlm.nih.gov/pubmed/32809017
http://dx.doi.org/10.1093/aje/kwaa169
_version_ 1783661120581533696
author Perumal, Nandita
Roth, Daniel E
Cole, Donald C
Zlotkin, Stanley H
Perdrizet, Johnna
Barros, Aluisio J D
Santos, Ina S
Matijasevich, Alicia
Bassani, Diego G
author_facet Perumal, Nandita
Roth, Daniel E
Cole, Donald C
Zlotkin, Stanley H
Perdrizet, Johnna
Barros, Aluisio J D
Santos, Ina S
Matijasevich, Alicia
Bassani, Diego G
author_sort Perumal, Nandita
collection PubMed
description Child growth standards are commonly used to derive age- and sex-standardized anthropometric indices but are often inappropriately applied to preterm-born children (<37 weeks of gestational age (GA)) in epidemiology studies. Using the 2004 Pelotas Birth Cohort, we examined the impact of correcting for GA in the application of child growth standards on the magnitude and direction of associations in 2 a priori–selected exposure-outcome scenarios: infant length-for-age z score (LAZ) and mid-childhood body mass index (scenario A), and infant LAZ and mid-childhood intelligence quotient (scenario B). GA was a confounder that had a strong (scenario A) or weak (scenario B) association with the outcome. Compared with uncorrected postnatal age, using GA-corrected postnatal age attenuated the magnitude of associations, particularly in early infancy, and changed inferences for associations at birth. Although differences in the magnitude of associations were small when GA was weakly associated with the outcome, model fit was meaningfully improved using corrected postnatal age. When estimating population-averaged associations with early childhood growth in studies where preterm- and term-born children are included, incorporating heterogeneity in GA at birth in the age scale used to standardize anthropometric indices postnatally provides a useful strategy to reduce standardization errors.
format Online
Article
Text
id pubmed-7936033
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-79360332021-03-10 Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes Perumal, Nandita Roth, Daniel E Cole, Donald C Zlotkin, Stanley H Perdrizet, Johnna Barros, Aluisio J D Santos, Ina S Matijasevich, Alicia Bassani, Diego G Am J Epidemiol Practice of Epidemiology Child growth standards are commonly used to derive age- and sex-standardized anthropometric indices but are often inappropriately applied to preterm-born children (<37 weeks of gestational age (GA)) in epidemiology studies. Using the 2004 Pelotas Birth Cohort, we examined the impact of correcting for GA in the application of child growth standards on the magnitude and direction of associations in 2 a priori–selected exposure-outcome scenarios: infant length-for-age z score (LAZ) and mid-childhood body mass index (scenario A), and infant LAZ and mid-childhood intelligence quotient (scenario B). GA was a confounder that had a strong (scenario A) or weak (scenario B) association with the outcome. Compared with uncorrected postnatal age, using GA-corrected postnatal age attenuated the magnitude of associations, particularly in early infancy, and changed inferences for associations at birth. Although differences in the magnitude of associations were small when GA was weakly associated with the outcome, model fit was meaningfully improved using corrected postnatal age. When estimating population-averaged associations with early childhood growth in studies where preterm- and term-born children are included, incorporating heterogeneity in GA at birth in the age scale used to standardize anthropometric indices postnatally provides a useful strategy to reduce standardization errors. Oxford University Press 2020-08-18 /pmc/articles/PMC7936033/ /pubmed/32809017 http://dx.doi.org/10.1093/aje/kwaa169 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Practice of Epidemiology
Perumal, Nandita
Roth, Daniel E
Cole, Donald C
Zlotkin, Stanley H
Perdrizet, Johnna
Barros, Aluisio J D
Santos, Ina S
Matijasevich, Alicia
Bassani, Diego G
Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes
title Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes
title_full Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes
title_fullStr Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes
title_full_unstemmed Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes
title_short Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes
title_sort effect of correcting the postnatal age of preterm-born children on measures of associations between infant length-for-age z scores and mid-childhood outcomes
topic Practice of Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936033/
https://www.ncbi.nlm.nih.gov/pubmed/32809017
http://dx.doi.org/10.1093/aje/kwaa169
work_keys_str_mv AT perumalnandita effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT rothdaniele effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT coledonaldc effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT zlotkinstanleyh effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT perdrizetjohnna effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT barrosaluisiojd effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT santosinas effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT matijasevichalicia effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes
AT bassanidiegog effectofcorrectingthepostnatalageofpretermbornchildrenonmeasuresofassociationsbetweeninfantlengthforagezscoresandmidchildhoodoutcomes