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Risk factors for failure to thrive in infancy depend on the anthropometric definitions used: the Copenhagen County Child Cohort.
Paediatr Perinat Epidemiol 2007; 21(5):418-31PP

Abstract

Failure to thrive (FTT) is the term widely used to describe poor weight gain in infancy, a condition associated with cognitive deficiency in later childhood. FTT has been investigated in earlier population studies, but little is known about risk factors for FTT or the sequence of events as this requires data to be collected prospectively within the first year of life. Furthermore, several different anthropometric criteria have been used to define FTT, and it is not known whether children identified by the different criteria are comparable. In the present population study we compared risk factors for FTT in a general infant population using different definitions of FTT. Three different criteria of FTT mirroring those used in previous population studies were applied to a birth cohort of 6090 infants. Sociodemographic data and prospectively collected information concerning physical and mental development of the children were obtained from National registries and standardised public health nurse records. Risk factors preceding each of the three 'types' of FTT were compared. The three criteria for FTT identified children with very different profiles and a prevalence of FTT ranging from around 2% to 21% in this affluent population. The criterion of slow weight gain conditional on birthweight (conditional weight gain) was associated with lower birthweight, small-for-gestational-age and deviant overall development. Adding low body mass index did not change this profile. In contrast, the commonly used criterion of downward crossing of centiles on an ordinary weight-for-age chart was associated with factors normally linked with low risk of adverse physical and mental development. Slow conditional weight gain, irrespective of additional thinness, seemed to identify infants with prenatal growth retardation and early developmental delays. In contrast, simple downward crossing of centiles seemed mainly to identify healthy low-risk infants, and thus, seems a poor screening measure of FTT in this affluent infant population. Thus, conditional weight gain appears to be the most sensible measure of FTT at present. However, only longitudinal studies including different anthropometric measures and different outcomes can unravel the discriminating power of the different FTT definitions concerning long-term prognosis.

Authors+Show Affiliations

Research Centre for Prevention and Health, and Child and Adolescent Psychiatric Centre, Copenhagen University Hospital, Glostrup, Denmark. else.marie.olsen@dadlnet.dkNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17697072

Citation

Olsen, Else M., et al. "Risk Factors for Failure to Thrive in Infancy Depend On the Anthropometric Definitions Used: the Copenhagen County Child Cohort." Paediatric and Perinatal Epidemiology, vol. 21, no. 5, 2007, pp. 418-31.
Olsen EM, Skovgaard AM, Weile B, et al. Risk factors for failure to thrive in infancy depend on the anthropometric definitions used: the Copenhagen County Child Cohort. Paediatr Perinat Epidemiol. 2007;21(5):418-31.
Olsen, E. M., Skovgaard, A. M., Weile, B., & Jørgensen, T. (2007). Risk factors for failure to thrive in infancy depend on the anthropometric definitions used: the Copenhagen County Child Cohort. Paediatric and Perinatal Epidemiology, 21(5), pp. 418-31.
Olsen EM, et al. Risk Factors for Failure to Thrive in Infancy Depend On the Anthropometric Definitions Used: the Copenhagen County Child Cohort. Paediatr Perinat Epidemiol. 2007;21(5):418-31. PubMed PMID: 17697072.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for failure to thrive in infancy depend on the anthropometric definitions used: the Copenhagen County Child Cohort. AU - Olsen,Else M, AU - Skovgaard,Anne M, AU - Weile,Birgitte, AU - Jørgensen,Torben, PY - 2007/8/19/pubmed PY - 2007/11/14/medline PY - 2007/8/19/entrez SP - 418 EP - 31 JF - Paediatric and perinatal epidemiology JO - Paediatr Perinat Epidemiol VL - 21 IS - 5 N2 - Failure to thrive (FTT) is the term widely used to describe poor weight gain in infancy, a condition associated with cognitive deficiency in later childhood. FTT has been investigated in earlier population studies, but little is known about risk factors for FTT or the sequence of events as this requires data to be collected prospectively within the first year of life. Furthermore, several different anthropometric criteria have been used to define FTT, and it is not known whether children identified by the different criteria are comparable. In the present population study we compared risk factors for FTT in a general infant population using different definitions of FTT. Three different criteria of FTT mirroring those used in previous population studies were applied to a birth cohort of 6090 infants. Sociodemographic data and prospectively collected information concerning physical and mental development of the children were obtained from National registries and standardised public health nurse records. Risk factors preceding each of the three 'types' of FTT were compared. The three criteria for FTT identified children with very different profiles and a prevalence of FTT ranging from around 2% to 21% in this affluent population. The criterion of slow weight gain conditional on birthweight (conditional weight gain) was associated with lower birthweight, small-for-gestational-age and deviant overall development. Adding low body mass index did not change this profile. In contrast, the commonly used criterion of downward crossing of centiles on an ordinary weight-for-age chart was associated with factors normally linked with low risk of adverse physical and mental development. Slow conditional weight gain, irrespective of additional thinness, seemed to identify infants with prenatal growth retardation and early developmental delays. In contrast, simple downward crossing of centiles seemed mainly to identify healthy low-risk infants, and thus, seems a poor screening measure of FTT in this affluent infant population. Thus, conditional weight gain appears to be the most sensible measure of FTT at present. However, only longitudinal studies including different anthropometric measures and different outcomes can unravel the discriminating power of the different FTT definitions concerning long-term prognosis. SN - 0269-5022 UR - https://www.unboundmedicine.com/medline/citation/17697072/Risk_factors_for_failure_to_thrive_in_infancy_depend_on_the_anthropometric_definitions_used:_the_Copenhagen_County_Child_Cohort_ L2 - https://doi.org/10.1111/j.1365-3016.2007.00851.x DB - PRIME DP - Unbound Medicine ER -