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dc.contributor.authorMadan, Emily Marcene
dc.date.accessioned2018-10-23T13:21:15Z
dc.date.available2018-10-23T13:21:15Z
dc.date.issued2018-05-30
dc.identifier.otherMadan_cornellgrad_0058F_10804
dc.identifier.otherhttp://dissertations.umi.com/cornellgrad:10804
dc.identifier.otherbibid: 10489381
dc.identifier.urihttps://hdl.handle.net/1813/59297
dc.description.abstractIndia has the highest number of undernourished children in the world. Rural agriculturalists suffer a high burden of undernutrition and are exposed to health and nutrition risks that vary throughout the year. Recent estimates of undernutrition based on growth from 0-6 months of age are high, but the risk factors for this poor growth are understudied. Pregnant women (n=599) were recruited from nine selected villages in Shivgarh, Uttar Pradesh for a longitudinal study. Mother-infant pairs were visited monthly from 0-6 months of infant age. Repeated maternal and infant health information and anthropometry were collected. Gestational age and maternal height were associated with larger newborn size. Female sex, primiparity, and being food insecure were associated with smaller newborn size. Compared to the overall sample means, infants conceived from July-September 2014 and April-June 2014 were approximately 200 g lighter (p=0.02) and 0.5 cm shorter (p=0.08), respectively. Infants who began the 1-4 month interval of growth from August-October 2015 had rates of length growth that were 0.064 ± 0.016 cm/month lower (p<0.001). We observed no monthly differences in rates of weight growth. In the 1-4 month growth interval, female sex and maternal work in agriculture were associated with slower rates of growth. Exclusive breastfeeding was associated with faster rates of growth. Newborn length and maternal morbidity were associated with slower and faster rates of length growth, respectively. Primiparity and newborn weight were associated with faster rates of weight growth (p<0.1). Unvaccinated infants had significantly slower growth related to increased morbidity (interaction p=0.001). Infants born from August-October 2015 had significantly slower length growth related to increased time spent in childcare (interaction p=0.019). This research shows that both prenatal and early postnatal determinants of poor growth contribute to small size at six months of age and confirms the important predictors of growth observed in other settings. Season was a relatively weak predictor of growth in this setting, but may be a stronger predictor in primarily rain-fed agricultural areas. Intervention strategies to address modifiable risk factors for poor infant growth are needed during both the prenatal and postnatal periods for positive impacts on early postnatal growth.
dc.language.isoen_US
dc.subjectSouth Asian studies
dc.subjectAgriculture
dc.subjectNutrition
dc.subjectgrowth
dc.subjectIndia
dc.subjectInfants
dc.titleMONTHLY VARIATION IN INFANT WEIGHT AND LENGTH GROWTH IN RURAL UTTAR PRADESH, INDIA
dc.typedissertation or thesis
thesis.degree.disciplineNutrition
thesis.degree.grantorCornell University
thesis.degree.levelDoctor of Philosophy
thesis.degree.namePh. D., Nutrition
dc.contributor.chairHaas, Jere Douglas
dc.contributor.committeeMemberPelletier, David Louis
dc.contributor.committeeMemberFrongillo, Edward A., Jr
dc.contributor.committeeMemberBarrett, Christopher
dc.contributor.committeeMemberRasmussen, Kathleen Maher
dc.contributor.committeeMemberMenon, Purnima
dcterms.licensehttps://hdl.handle.net/1813/59810
dc.identifier.doihttps://doi.org/10.7298/X4B856DW


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