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In developing countries, shorter maternal height associated with higher death rates for children

Date:
April 21, 2010
Source:
JAMA and Archives Journals
Summary:
Among 54 low- to middle-income countries, a mother's shorter height is associated with a higher rate of death for her children and a greater likelihood of these children being underweight and having a reduced rate of growth, according to a new study.

Among 54 low- to middle-income countries, a mother's shorter height is associated with a higher rate of death for her children and a greater likelihood of these children being underweight and having a reduced rate of growth, according to a study in the April 21 issue of JAMA.

Emre Ozaltin, M.Sc., Kenneth Hill, Ph.D., and S. V. Subramanian, Ph.D., of the Harvard School of Public Health, Boston, investigated the potential long-term effects of maternal stature on offspring mortality, underweight, stunting, and wasting in infancy and early childhood. The study included an analysis of 109 Demographic and Health Surveys in 54 low- to middle-income countries, conducted between 1991 and 2008. The study population consisted of a nationally representative cross-sectional sample of children ages 0 to 59 months born to mothers ages 15 to 49 years. Sample sizes were 2,661,519 (mortality), 587,096 (underweight), 558,347 (stunting), and 568,609 (wasting) children. The average response rate across surveys in the mortality data set was 92.8 percent.

Of the more than 2.6 million children in the study, 11.7 percent died before reaching 5 years of age. The prevalence of child mortality ranged from 24.7 percent in Niger to 3.3 percent in Jordan.

In adjusted models, a 0.4 inch increase in maternal height was associated with a decreased risk of offspring mortality, underweight, stunting, and wasting. Compared with the tallest mothers (5'3" or taller), each lower height category had substantially higher risk of child mortality, with children born to mothers of height shorter than 4'9" having an increased risk of death of nearly 40 percent. Mortality risk associated with increased height was decreased in 52 of 54 countries and was statistically significant in 46 of 54 countries.

"Underscoring the policy significance of this association, for child mortality, the effect of being in the lowest height category (relative to the tallest) was approximately 70 percent and 80 percent of the size of the effect of having no education or being in the poorest income quintile, respectively. For childhood underweight and stunting, maternal height was the most important factor, with an effect size about twice that of being in the lowest education category and 1.5 times that of being in the poorest quintile," the authors write.

"This suggests the presence of an intergenerational transmission from mother's own nutrition, disease, and socioeconomic circumstances during her childhood to her offspring's health and mortality in their infancy and childhood."

Editorial: Maternal Height and Risk of Child Mortality and Undernutrition

Parul Christian, Dr.P.H., M.Sc., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, writes in an accompanying editorial that maternal stature, overall maternal nutritional status, and the factors that give rise to them needs more emphasis, especially because early growth failure is known to track into childhood and beyond. She calls attention to the challenge and potential public health value of addressing maternal undernutrition and maternal short stature as an approach to reducing child mortality in low- and middle-income countries.

Christian writes, "The speculation by Ozaltin et al that the intergenerational transmission from the mother's environmental milieu during her own childhood (and also fetal life) to her offspring's growth and survival may be plausible in explaining the relationship between maternal stature and child mortality and undernutrition, although further investigation of this phenomenon in cohort studies is needed. Also, because short maternal stature is less common in sub-Saharan Africa, the risk of child mortality and undernutrition attributable to maternal height may be expected to be correspondingly lower in this region. This needs examination as does the independent and adjusted association of maternal body mass index to childhood outcomes."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. E. Ozaltin, K. Hill, S. V. Subramanian. Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- to Middle-Income Countries. JAMA: The Journal of the American Medical Association, 2010; 303 (15): 1507 DOI: 10.1001/jama.2010.450
  2. P. Christian. Maternal Height and Risk of Child Mortality and Undernutrition. JAMA: The Journal of the American Medical Association, 2010; 303 (15): 1539 DOI: 10.1001/jama.2010.469

Cite This Page:

JAMA and Archives Journals. "In developing countries, shorter maternal height associated with higher death rates for children." ScienceDaily. ScienceDaily, 21 April 2010. <www.sciencedaily.com/releases/2010/04/100420161752.htm>.
JAMA and Archives Journals. (2010, April 21). In developing countries, shorter maternal height associated with higher death rates for children. ScienceDaily. Retrieved September 23, 2014 from www.sciencedaily.com/releases/2010/04/100420161752.htm
JAMA and Archives Journals. "In developing countries, shorter maternal height associated with higher death rates for children." ScienceDaily. www.sciencedaily.com/releases/2010/04/100420161752.htm (accessed September 23, 2014).

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