title: The first 1000 days of life: prenatal and postnatal risk factors for morbidity and growth in a birth cohort in southern India.
abstract: OBJECTIVE
  To estimate the burden and assess prenatal and postnatal determinants of illnesses experienced by children residing in a semiurban slum, during the first 1000 days of life.
  
  
  METHODS
  Community-based birth cohort
  
  
  METHODS
  Southern India
  
  
  METHODS
  Four hundred and ninety-seven children of 561 pregnant women recruited and followed for 2 years with surveillance and anthropometry.
  
  
  METHODS
  Incidence rates of illness; rates of clinic visits and hospitalisations; factors associated with low birth weight, various illnesses and growth.
  
  
  RESULTS
  Data on 10 377.7 child-months of follow-up estimated an average rate of 14.8 illnesses/child-year. Gastrointestinal and respiratory illnesses were 20.6% and 47.8% of the total disease burden, respectively. The hospitalisation rate reduced from 46/100 child-years during infancy to 19/100 child-years in the second year. Anaemia during pregnancy (OR=2.3, 95% CI=1.08 to 5.18), less than four antenatal visits (OR=6.8, 95% CI=2.1 to 22.5) and preterm birth (OR=3.3, 95% CI=1.1 to 9.7) were independent prenatal risk factors for low birth weight. Female gender (HR=0.88, 95% CI=0.79 to 0.99) and 6 months of exclusive breast feeding (HR=0.76, 95% CI=0.66 to 0.88) offered protection against all morbidity. Average monthly height and weight gain were lower in female child and children exclusively breast fed for 6 months.
  
  
  CONCLUSIONS
  The high morbidity in Indian slum children in the first 1000 days of life was mainly due to prenatal factors and gastrointestinal and respiratory illness. Policymakers need disease prevalence and pathways to target high-risk groups with appropriate interventions in the community.
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Deepthi
authors: D
authors: Kattula
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Rajiv
authors: R
authors: Sarkar
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Prabhu
authors: P
authors: Sivarathinaswamy
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Vasanthakumar
authors: V
authors: Velusamy
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Srinivasan
authors: S
authors: Venugopal
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts, USA.
authors: Elena N
authors: EN
authors: Naumova
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Jayaprakash
authors: J
authors: Muliyil
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.
authors: Honorine
authors: H
authors: Ward
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Gagandeep
authors: G
authors: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011204:Poverty Areas; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult