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      Length and weight growth trends for children less than two years old in Zanjan, Iran: Longitudinal modeling

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          Abstract

          Background: Growth failure in children less than five years old can lead to the serious complications such as increased mortality, learning difficulties or physical disability. The aim of this study was to investigate the nonorganic factors affecting the growth trend in less than two years children living in Zanjan, Iran.

          Methods: This longitudinal study was conducted on a sample of 3566 children less than two years old in Zanjan. Weight and length growth trends were recorded as ordinal variables and analyzed by longitudinal marginal model.

          Results: About 12% (n=289) and 8% (n=212) of children had at least one decline/stagnation in the weight and length growth curve, respectively. Based on the marginal model, the effect of the child’s age and residence area on the weight and length growth trends were statistically significant (p<0.05).

          Conclusion: Given the relatively high prevalence of growth failure among studied children less than two years old in rural areas of Zanjan, raising the awareness of parents in rural areas about feeding and nutritional behaviors of children seems an important issue. Additionally, healthcare providers should mostly focus on monitoring the growth of children older than 12 months.

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          Most cited references20

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          2000 CDC Growth Charts for the United States: methods and development.

          This report provides detailed information on how the 2000 Centers for Disease Control and Prevention (CDC) growth charts for the United States were developed, expanding upon the report that accompanied the initial release of the charts in 2000. The growth charts were developed with data from five national health examination surveys and limited supplemental data. Smoothed percentile curves were developed in two stages. In the first stage, selected empirical percentiles were smoothed with a variety of parametric and nonparametric procedures. In the second stage, parameters were created to obtain the final curves, additional percentiles and z-scores. The revised charts were evaluated using statistical and graphical measures. The 1977 National Center for Health Statistics (NCHS) growth charts were revised for infants (birth to 36 months) and older children (2 to 20 years). New body mass index-for-age (BMI-for-age) charts were created. Use of national data improved the transition from the infant charts to those for older children. The evaluation of the charts found no large or systematic differences between the smoothed percentiles and the empirical data. The 2000 CDC growth charts were developed with improved data and statistical procedures. Health care providers now have an instrument for growth screening that better represents the racial-ethnic diversity and combination of breast- and formula-feeding in the United States. It is recommended that these charts replace the 1977 NCHS charts when assessing the size and growth patterns of infants, children, and adolescents.
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            NCHS growth curves for children birth-18 years. United States.

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              Risk factors for undernutrition of young children in a rural area of South Africa.

              To identify the factors associated with childhood undernutrition. Cross-sectional survey. Hlabisa health district in KwaZulu/Natal, South Africa. Eight hundred and sixty-eight children aged 3-59 months. Questionnaire survey and anthropometric survey of 516 random households with children in the health district. Multivariate analysis took into account the hierarchical relationships between the proposed risk factors. This conceptual model was built up during qualitative studies and with reference to international research in this area. The mean Z-scores for weight-for-age and height-for-age were -0.52 (95% confidence interval (CI) -0.44 to -0.60) and -1.25 (95% CI -1.15 to -1.35), respectively. Of the children, 26.3% (95% CI 23.3-29.3%) were stunted, 12.0% (95% CI 9.8-4.2%) were underweight-for-age (UWFA) and only 1.3% were wasted. Migrant father, mother's education, literate mother, whether the house was made of traditional materials, the presence of a toilet, whether the last child was breast-fed, duration of breast-feeding and birth weight were found to be significantly related to UWFA, the latter with an odds ratio of more than eight. While there are individual health and feeding behaviours that need to be addressed, this study has also uncovered the maternal and socio-economic factors which present an array of constraints in the social environment shaping the infant feeding and caring practices employed by women. For the full potential of nutrition promotion activities to be realised, there is a need to address some of these 'deeper' constraints.
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                Author and article information

                Journal
                Med J Islam Repub Iran
                Med J Islam Repub Iran
                MJIRI
                Med J Islam Repub Iran
                Medical Journal of the Islamic Republic of Iran
                Iran University of Medical Sciences
                1016-1430
                2251-6840
                2016
                23 May 2016
                : 30
                : 374
                Affiliations
                1 PhD Student of Biostatistics, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. nasim.vahabi@ 123456modares.ac.ir
                2 Professor of Biostatistics, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. kazem_an@ 123456modares.ac.ir
                3 PhD Student of Biostatistics, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. r.fallahvalamdehi@ 123456modares.ac.ir
                Author notes
                (Corresponding author) Professor of Biostatistics, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. kazem_an@ 123456modares.ac.ir
                Article
                4972070
                27493918
                0832dba6-dcb2-4509-a06b-b73f23ee9e57
                © 2016 Iran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 13 September 2015
                : 11 November 2015
                Page count
                Tables: 5, References: 25, Pages: 8
                Categories
                Original Article

                weight growth trend,length growth trend,longitudinal data,marginal model

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