Background

Children during early years undergo rapid growth that can be affected by a multitude of factors that happen during pregnancy or after birth, and this may lead to childhood undernutrition. The aim of this study was to examine the effect of intrauterine foetal growth on early child growth in early childhood in drought affected rural Ethiopia.

Method

We conducted a community-based study using cohort design in Adami Tullu, East Shewa Zone of Oromia Regional State, Ethiopia. We enrolled pregnant mothers below 24 weeks of pregnancy and followed them using serial ultrasound measurements and their children up to 11 to 24 months post-delivery. Z-scores of estimated foetal weight, birth weight and birth length were calculated using INTERGROWTH 21^st application software. Nutritional indices; Z scores of height - for - age (HAZ), weight- for-age (WAZ ) and weight- for- height (WHZ) were calculated using the 2006 WHO  child growth standards.

We used multiple linear regression to determine potential association between selected variables with birth weight Z score, HAZ scores, WAZ scores and WHZ scores. Beta regression coefficient was used to present the association both in univariate and multivariate regression.

Result

We included 675 mothers with singleton pregnancy and 1671 ultrasound measurements. Majority of the mothers were in the age groups 20 to 24 years. The proportion of low birth weight was 48 (7.9%) and gestation at birth was less than 37 weeks for 31 (4.9%) of new-borns. The prevalence of stunting was 51.3%, underweight 15.8% and wasting 11.7%.  In multivariate regression analysis, estimated fetal weight from 33 to 38 weeks of gestation was significantly associated with birth weight z-scores. Birth length z-score (β = 0.22, P = 0.001), and maternal height (β = 0.12, P = 0.04) were strongly associated with stunting.  Estimated fetal weight z-scores, birth weight z-score and birth length z-score were not significantly associated with both underweight and wasting. Middle socioeconomic class category had significant association with underweight (β = 0.19, P = 0.007) and wasting (β = 0.19, P = 0.004). Adjusted R-squared was 8.6%.

Conclusion

Intrauterine estimated fetal weight has effect on birth weight but not on child growth. Birth length z-score, and maternal height were strongly associated with stunting while middle class socioeconomic category had significant association with underweight and wasting. 

Key words: Intrauterine growth, growth faltering, ultrasound, community