Comparison of Growth Curve Estimates of Infants in São Tomé Island, Africa, with the WHO Growth Standards: A Birth Cohort Study

This birth cohort study compared the infant growth curve estimates in São Tomé Island to the WHO growth standards. Despite this island belonging to a lower-middle-income country, there were several factors favorable for growth that were present. Four-hundred and seventy-five full-term singleton appropriate for-gestational-age infants were enrolled and followed-up to 24 months of age. Weight-for-age, length-for-age, weight-for-length, body mass index-for-age, head circumference-for-age, weight velocity, and length velocity curves were estimated and compared to the WHO standards. In the first 6 months of age, the weight gain was adequate in the presence of a high prevalence of exclusive breastfeeding. Thereafter, weight trajectories tracked close to the WHO standards, except for a progressive decline in the infants growing in higher percentiles, especially in girls. Median length at birth was below the median WHO standards, followed by an early postnatal velocity spurt, which probably reflected the transition from an unfavorable to a more favorable postnatal environment. Thereafter, linear growth faltering was observed without relevant deterioration up to 24 months of age, which was probably due to the presence of protective factors. These results may be useful to implement strategies to further approximate infant growth in São Tomé Island to the WHO standards