Cited By (since 1996): 1 Export Date: 1 September 2008 Source: Scopus CODEN: EHDED doi: 10.1016/j.earlhumdev.2005.06.006 Language of Original Document: English Correspondence Address: Brabin, B.J.; Child and Reproductive Health Group; Liverpool School of Tropical Medicine; Pembroke Place Liverpool L3 5QA, United Kingdom; email: b.j.brabin@liverpool.ac.uk References: Simondon, K.B., Simondon, F., Cornu, A., Delpeuch, F., The utility of infancy weight curves for the prediction of linear growth retardation in pre-school children (1991) Acta Paediatr Scand, 80, pp. 1-6; Sinclair-Smith, C., Dinsdale, F., Emery, J., Evidence of duration and type of illness in children found unexpectedly dead (1976) Arch Dis Child, 51, pp. 424-429; Dowdney, L., Skuse, D., Heptinstall, E., Puckering, C., Zur-Szpiro, S., Growth retardation and developmental delay among inner-city children (1987) J Child Psychol Psychiatry Allied Discipl, 28, pp. 529-541; Barker, D.J.P., Winter, P.D., Osmond, C., Margetts, B., Simmonds, S.J., Weight in infancy and death from ischaemic heart disease (1989) Lancet, 1, pp. 577-580; Ter Kuile, F.O., Terlouw, D.J., Kariuki, S.K., Phillips-Howard, P.A., Mirel, L.B., Hawley, W.A., Impact of permethrin-treated bed nets on malaria, anaemia, growth in infants in an area of intense perennial malaria transmission in western Kenya (2003) Am J Trop Med Hyg, 68 (4 SUPPL.), pp. 68-77; Sackey, M.E., Weigel, M.M., Armijos, R.X., Predictors and nutritional consequences of intestinal parasitic infections in rural Ecuadorian children (2003) J Trop Pediatr, 49 (1), pp. 17-23; Steketee, R.W., Pregnancy, nutrition and parasitic diseases (2003) J Nutr, 133 (5 SUPPL. 2), pp. 1661S-1667S; Newell, M.L., Borja, M.C., Peckham, C., European Collaborative study. 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Walter Nutrition in pregnancy and growth Karger Basel; Brabin, B.J., Fletcher, K.A., Brown, N., Do disturbances within the folate pathway contribute to low birthweight in malaria (2003) Trends Parasitol, 19, pp. 39-43; Menendez, C., Malaria in pregnancy (1995) Parasitol Today, 11, pp. 178-183; Le Cessie, S., Verhoeff, F.H., Meningistie, G., Kazembe, P., Broadhead, R., Brabin, B.J., Changes in haemoglobin levels in infants in Malawi: Effect of low birthweight and fetal anaemia (2002) Arch Dis Child Neonatal Ed, 86, pp. 182-F187; Brabin, B.J., Kalanda, B.F., Verhoeff, F.H., Chimsuku, L.H., Broadhead, R.L., Risk factors for fetal anaemia in a malarious area of Malawi (2004) Ann Trop Paediatr, 24, pp. 311-321; Okoko, B.J., Ota, M.O., Yamuah, L.K., Idiong, D., Mkpanam, S.N., Avieka, A., Influence of placental malaria infection on foetal outcome in the Gambia: Twenty years after Ian McGregor (2002) J Health Popul Nutr, 20 (1), pp. 4-11; Brabin, B.J., Ramagosa, C., Abdelgali, S., Menendez, C., Verhoeff, F.H., McGready, R., The sick placenta-the role of malaria (2004) Placenta, 25, pp. 359-378; Kalanda, B.F., (2004) Fetal and Infant Growth and Nutrition in a Malarious Area of Southern Malawi, PhD thesis, University of Liverpool; Martorell, R., Schroeder, D.G., Rivera, J.A., Kaplowitz, H.J., Patterns of linear growth in rural Guatemalan adolescents and children (1995) J Nutr, 125, pp. 1060S-1067S; Cole, T.J., Relating growth rate to environmental factors-methodological problems in the study of growth-infection interaction (1989) Acta Paediatr Suppl, 350, pp. 14-20; Leandro-Merhi, V.A., Dos Santos-Vilela, M.M., Da Silva, M.N., Lopez, F.A., De Azevedo-Barros-Filho, A., Evolution of nutritional status of infants infected with the human immunodeficiency virus (2000) Sao Paulo Med J/Rev Paul Med, 118 (5), pp. 148-153; Cleland, J., Van Ginneken, J.K., Maternal education and child survival in developing countries: The search for pathways of influence (1988) Soc Sci Med, 27, pp. 1357-1368 Introduction: Infant growth has not been studied in developing countries in relation to maternal factors related to malaria in pregnancy and maternal illiteracy. Objective: To describe growth patterns in infants with low and normal birthweight and determine maternal risk factors for infant undernutrition. Methods: Babies born in a rural district of southern Malawi were recruited. An infant cohort was selected on the basis of low or normal birthweight. Weight and length were recorded at birth and at 4-weekly intervals until at 52 weeks after birth. Maternal characteristics at first antenatal attendance and delivery were obtained. Odds ratios in univariate analysis were adjusted for birthweight. Factors included in the multivariate regression included maternal illiteracy, season of birth, maternal iron deficiency and number of infant illness episodes. Results: Low birthweight infants were shorter and lighter throughout infancy than either normal birthweight or international reference values. At 12 months, placental or peripheral malaria at delivery (adjusted odds 1.8; 1.0, 3.1), number of infant illness episodes (AOR = 2.1; 1.2, 3.6) and maternal illiteracy (AOR = 2.7; 1.5, 4.9) were independently associated with low weight for age. Maternal short stature (AOR = 1.8; 1.1. 3.2), male sex (AOR = 2.4; 1.4, 4.1), number of infant illness episodes (AOR = 2.6; 1.5, 4.4), and birth in the rainy season (2.1; 1.2, 3.7) were independently associated with stunting. Placental or peripheral malaria at delivery (AOR = 2.2; 1.1, 4.4) and number of illness episodes (AOR = 2.2; 1.1, 4.5) were independently associated with thinness. Conclusion: Malaria during pregnancy and maternal illiteracy are important maternal characteristics associated with infant undernutrition. Innovative health/literacy strategies are required to address malaria control in pregnancy in order to reduce the magnitude of its effects on infant undernutrition. ™ 2005 Elsevier Ireland Ltd. All rights reserved