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Research Project: Improving Nutrition and Physical Activity Related Health Behaviors in Children and Their Environment

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Title: Infant growth outcomes from birth to 12 months of age: findings from the Delta Healthy Sprouts randomized comparative impact trial

Author
item Thomson, Jessica
item Goodman, Melissa
item Tussing-humphreys, Lisa - University Of Illinois
item Landry, Alicia - University Of Central Arkansas

Submitted to: Obesity Science & Practice
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/22/2018
Publication Date: 5/17/2018
Citation: Thomson, J.L., Goodman, M.H., Tussing-Humphreys, L.M., Landry, A.S. 2018. Infant growth outcomes from birth to 12 months of age: findings from the Delta Healthy Sprouts randomized comparative impact trial. Obesity Science & Practice. 4(4):299-307. https://doi.org/10.1002/osp4.272.
DOI: https://doi.org/10.1002/osp4.272

Interpretive Summary: In the United States, 8% of infants and toddlers are overweight and 17% of children are obese with rates higher in racial/ethnic minority children. The prenatal, infancy, and early childhood periods are key to the development and thus prevention of obesity and its consequences in children. Thus lifestyle interventions that are designed for both the gestational and early postnatal periods may have a positive impact on childhood overweight/obesity. The primary purpose of this paper was to determine if infant growth outcomes differed between treatment arms of a maternal, infant, and early childhood home visiting project. Pregnant women at least 18 years of age, less than 19 weeks pregnant, and residing in a lower Mississippi Delta county were recruited between March 2013 and December 2014. Postnatal data, including infant length and weight, was collected from 24 experimental and 30 control participants between September 2013 and May 2016. Approximately three-fourths of infants in both treatment arms were classified as overweight and experienced rapid weight gain during the first 12 months of life. Average time to overweight classification was between 3 and 4 months while average time to rapid weight gain was between 6 and 7 months for infants in both treatment arms. No treatment differences were observed for either infant growth outcome. As compared to the standard (control) curriculum, the diet and physical activity enhanced curriculum was not effective at improving growth outcomes of infants born to this group of rural, Southern, primarily African American women. Given the majority of infants experienced adverse weight outcomes in the first year of life, concerted efforts are needed to break the intergenerational cycle of obesity present in this region of the nation

Technical Abstract: Objective: Multicomponent lifestyle modification interventions designed for gestational and early postnatal periods may be key to preventing obesity in children. The primary objective of the study was to determine if infant growth outcomes differed between treatment arms of an 18-month, maternal, infant, and early childhood home visiting project. Methods: Pregnant women at least 18 years of age, less than 19 weeks pregnant, and residing in a lower Mississippi Delta county were recruited between March 2013 and December 2014. Postnatal data was collected from 24 experimental and 30 control participants between September 2013 and May 2016. Infant growth outcomes were modeled as time-to-event data using Kaplan-Meier survival curves with log rank tests to determine if survival curves differed between treatment arms. Results: Retention rates for the experimental and control arms were 88% (21/24) and 83% (25/30), respectively. Approximately three-fourths of infants in both treatment arms were classified as overweight and experienced rapid weight gain during the first 12 months of life. No differences between median times to classification as overweight (3-4 months) nor to experiencing rapid weight gain (6-7 months) were observed between treatment arms. Conclusions: As compared to a standard educational (control) curriculum, an educational curriculum enhanced with diet and physical activity components was not effective at improving infant growth outcomes.