At discretion of the attending neonatologist, the dosage of multicomponent fortifier was also augmented in infants showing persistently faltering growth.
Children who faltered, children who were persistently stunted, and children who recovered all had lower receptive vocabulary scores (effect-size ranges: 0.07 0.24, 0.13 0.31, and 0.01 0.25, respectively) than did children who were never stunted.
Children who faltered and those who were persistently stunted had lower reading-comprehension scores than those of children who were never stunted (effect-size ranges: 0.05 0.37 and 0.24 0.38, respectively).
The mean change in the HAZ varied by category as follows: recovered [range: from 1.08 (Vietnam) to 1.88 (Ethiopia)], faltered [range: from −1.45 (Ethiopia) to −0.85 (Peru ], persistently stunted [range: from 0.15 (Vietnam) to 0.83 (Ethiopia)], and never stunted [range: from −0.08 (Ethiopia) to 0.03 (Peru)].
In most cases, for each cognitive measure, children who recovered had significantly better scores than did children who were persistently stunted, although generally scores were similar to those of children who faltered.
We also characterized growth as recovered (stunted at age 1 y and not at age 8 y), faltered (not stunted at age 1 y and stunted at age 8 y), persistently stunted (stunted at ages 1 and 8 y), or never stunted (not stunted at ages 1 and 8 y).
We developed a 4-category representation of growth based on the aHAZ(1) and growth by the height-for-age z score at age 8 y, namely recovered (stunted at age 1 y and not stunted at 8 y), faltered (not stunted at age 1 y and stunted at age 8 y), persistently stunted (stunted at ages 1 and 8 y), or never stunted (not stunted at ages 1 or 8 y; considered the reference).
Compared with children who were never stunted, mathematics scores of children who were persistently stunted or recovered were lower (effect-size ranges: 0.22 0.48 and 0.12 0.21, respectively), whereas children who faltered showed no clear difference from children who were never stunted (Table 3 ).
Compared with children who were never stunted, children who were persistently stunted were more likely to be overage for grade (OR range across countries: 1.71 2.79; Table 2 ); children who faltered or recovered were only more likely to be overage for grade in one-half of cases (OR range: 1.35 2.40 and 0.85 2.20, respectively).
