title: Associations of growth trajectories in infancy and early childhood with later childhood outcomes.
abstract: BACKGROUND
  Weight and length at birth (which represent fetal growth) and weight and length or height gain during childhood (which potentially represent catch-up growth) may be related to later health outcomes. However, methods for the assessment of such relations are complex and underdeveloped.
  
  
  OBJECTIVE
  We aimed to describe childhood weight and length or height trajectories and to relate these to later outcomes by using rash at age 6.5 y as an example.
  
  
  METHODS
  The data came from a prospective cohort study in Belarus in 10,494 children born in 31 hospitals that participated in a cluster randomized trial of breastfeeding promotion. Weight and length or height were measured at birth, at scheduled clinic visits up to 1 y, and at 6.5 y; intermediate measures were obtained from routine child health records. Linear spline multilevel models for weight and length or height were used to estimate each child's deviance from average birth weight, birth length, weight, and length or height gain velocity in each time period. Logistic regression was used to relate the outcome (parental report of rash at 6.5 y) to these weight and length or height estimates.
  
  
  RESULTS
  The best-fitting splines for length or height and weight had knots at 3 and 12 mo, with another knot at 34 mo for height. The only relation between weight and length or height and reported rash was a positive association with weight gain velocity between 12 and 34 mo (odds ratio per SD increase in weight gain velocity: 1.11; 95% CI: 1.01, 1.22).
  
  
  CONCLUSIONS
  Advantages of multilevel models include no restriction to measures at arbitrary times or to individuals with complete data and allowance for measurement error. This trial was registered at isrctn.org as ISRCTN37687716.
authors.affiliation: Department of Social Medicine, University of Bristol, Bristol, United Kingdom. kate.tilling@bristol.ac.uk
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.forename: Neil M
authors.initials: NM
authors.lastname: Davies
authors.forename: Emily
authors.initials: E
authors.lastname: Nicoli
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kramer
authors.forename: Rita
authors.initials: R
authors.lastname: Patel
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.forename: Richard M
authors.initials: RM
authors.lastname: Martin
mesh_terms: D001724:Birth Weight; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D001942:Breast Feeding; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D016000:Cluster Analysis; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D002094:Republic of Belarus; D015430:Weight Gain