Diverse physical growth trajectories in institutionalized portuguese children below age 3: relation to child, family, and institutional factors

The authors would like to thank the students involved in the data collection and coding, and especially the children, caregivers, and other institutional staff who participated in the study.
Funding from Fundação para a Ciência e Tecnologia.
Objective: To identify and analyze diverse longitudinal trajectories of physical growth of institutionalized children and their relation to child, family, and institutional factors.
Methods: 49 institutionalized children were studied for 9 months after admission. Weight, height, and head circumference were measured on 4 occasions, beginning at admission. Data were analyzed using latent class analysis, yielding diverse patterns of growth for each feature, and relations with child characteristics, early family risk factors, and institutional relational care were investigated.
Results: For each growth feature, 4 classes emerged: ‘‘Persistently Low,’’ ‘‘Improving,’’ ‘‘Deteriorating,’’ and ‘‘Persistently High.’’ Younger age at admission was a risk factor for impaired physical growth across all domains. Physical characteristics at birth were associated with trajectories across all domains. Lower prenatal risk and better institutional relational care were associated with Improving weight over time.
Conclusions: Discussion highlights the role of children’s physical features at birth, prenatal risk, and caregiver’s cooperation with the child in explaining differential trajectories.
This research was supported in part by grant 13/06 from Fundação BIAL and by grant PTDC/PSI-PCL/101506/2008 from Fundação para a Ciência e Tecnologia.