Abstract
Objective: To evaluate the association between stunting in children and maternal short stature, controlling for potential environmental confounders.
Design: 1988 Mexico National Nutrition Survey.
Setting: Mexico
Subjects: The final sample size was 4663 pairs of children (<5 y) and their mothers (12–49 y) from a total of 13 236 surveyed houses.
Main outcome measures: Stunting (height-for-age Z-scores <−2).
Results: The prevalence of stunting in children was 19%, and 10% of the mothers exhibited short stature (<145 cm). In the crude analysis, mothers with short stature were significantly more likely to have stunted children (odds ratio (OR)=4.0; 95% confidence interval (CI)=3.2–4.8; P-value <0.001). In a multiple logistic regression model the OR for child stunting was reduced, but remained significant OR=2.0; 95% CI=1.6–2.6; P-value <0.001) after adjustment for region, urban/rural residence, socio-economic status, household size, child age and presence of infection in the past 14 d, and maternal age, body mass index (BMI), and educational level. Adjusted ORs varied between regions (Mexico City, OR=3.9; North Mexico, OR=3.1; Central Mexico, OR=2.0; South Mexico, OR=1.6. Comparison of crude vs adjusted estimates pointed to regional differences in the proportion of association between maternal and child short statures explained by environmental determinants.
Conclusions: Maternal stature, reflecting her potential height and early environment, appeared to contribute to child height independently of the shared risk factors that could affect stature. Nonetheless, we could explain much of the association between stunting in children and maternal short stature by environmental factors, and part of the residual variability may be due to unmeasured determinants. Regional differences pointed to a predominance of environmental factors in explaining child stunting in poorer regions.
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Contributions
Guarantor: S Hernández-Díaz.
Contributors: SH-D was lead author responsible for formulating the research questions and analytic strategy, conducting the analysis, and writing the manuscript; KEP worked in close collabortion with the first author in defining the hypothesis, interpreting the results and writing the manuscript; SD worked with the first author from the early stages of the project, contributing to the hypothesis definition and to the analysis plan; BH participated substantially in the interpretation of the results in the preparation of the manuscript; SP provided input in writing and through group discussion at the analysis and interpretation stages; SB contributed substantially to the interpretation of findings in the context of the literature on nutrition transition and intergenerational patterns; JS was responsible for the design, conduct and overall supervision of research emanating from the 1988 Mexican National Nutritional Survey, in coordination with JAR; JAR contributed substantially to the design and analytic strategy as well as interpretation of findings in the context of the literature on nutrition transition and intergenerational patterns.
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Hernández-Díaz, S., Peterson, K., Dixit, S. et al. Association of maternal short stature with stunting in Mexican children: common genes vs common environment. Eur J Clin Nutr 53, 938–945 (1999). https://doi.org/10.1038/sj.ejcn.1600876
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DOI: https://doi.org/10.1038/sj.ejcn.1600876
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