scholarly journals The psychological distress of parents is associated with reduced linear growth of children: evidence from a nationwide population survey

2020 ◽  
Author(s):  
Kun A Susiloretni ◽  
Emily R Smith ◽  
Suparmi ◽  
Marsum ◽  
Rina Agustina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Education ◽  
Linear Growth ◽  
Multinomial Logistic Regression ◽  
Occupational Status ◽  
Child Growth ◽  
Influential Factors ◽  
Parental Distress ◽  
Z Score ◽  
Self Reporting Questionnaire

AbstractBackgroundStunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized to be complex, most analyses have focused on biomedical determinants, with limited attention to social factors affecting care and nurturing in the home.ObjectivesTo identify the association between parental distress and linear growth and stunting and to examine z score loss due to any parental distress and socioeconomic, behavioral, and physiologic risk factors on for linear growthDesignCross sectional studyParticipants54,261 households from the Indonesia National Health Survey 2013. Main outcome measures. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire, with height-for-age z score (HAZ), stunting, and behavioral risk factors for stunting.ResultsMaternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.091, 0.13 and 0.21 z-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ < -1) by 38% and 39%, and the risk of moderate stunting (HAZ < -2) by 41% and 23%, respectively. Parental stress increased the risk of moderate and severe stunting by 67% and 41%. Any parental distress accounted for 5.6% of the modeled overall loss of HAZ-score due to interactions with socioeconomic status (low maternal occupational status, low wealth, low maternal occupation) and behavioral (poor garbage sanitation) factors, rendering it amongst the more influential factors on linear growth. The modeled overall loss of HAZ-score incorporating any parental distress was associated with socioeconomic factors (26.1%) including, in descending order, low maternal occupational status, low wealth, low maternal education, low paternal occupational status, rural residence; behavioral factors (15.3%) including open garbage disposal, unimproved water disposal, paternal smoking, not using iodized salt; physiological factors (13.5%) including low maternal height, female child, paternal height, maternal mid-upper arm circumference.ConclusionsThese findings highlight the complex etiology of stunting, and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents are essential to achieve child growth and development, and would likely foster taller, healthier, smarter, and thriving populations.

scholarly journals The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0246725
Author(s):  
Kun A. Susiloretni ◽  
Emily R. Smith ◽  
Suparmi ◽  
Marsum ◽  
Rina Agustina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Parental Stress ◽  
Maternal Education ◽  
Linear Growth ◽  
Multinomial Logistic Regression ◽  
Occupational Status ◽  
Parental Distress ◽  
Self Reporting Questionnaire ◽  
The Relationship

Background Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting. Methods We used data from the Indonesia National Health Survey 2013, including 46,315 children 6–59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire (SRQ20), with height-for-age z score (HAZ), stunting, and behavioral and other risk factors for stunting. Results Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.086 (95% CI -0.17, -0.00), 0.11 (95% CI -0.24, -0.02) and 0.19 (95% CI -0.37, -0.00) HAZ-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ <-1) by 33% (95% CI 1.17,1.50) and 37% (95% CI 1.18,1.60), and the risk of moderate stunting (HAZ <-2) by 25% (95% CI 1.10,1.43) and 28% (95% CI 1.08,1.51]), respectively. Parental stress increased the risk of moderate stunting by 40% (95% CI 1.06,1.85). Amongst specific groups of risk factors, the proportion of HAZ-score lost was associated with socioeconomic factors (30.3%) including, low wealth, low maternal occupational status, low maternal education, rural residence, and low paternal occupational status; physiological factors (15.5%) including low maternal height, low maternal mid-upper arm circumference, being male, low paternal height; behavioral factors (8.9%) including open garbage disposal, paternal smoking, not using iodized salt; and experiencing at least one infectious diseases episode (1.1%). Conclusions Maternal, paternal and parental stress were associated with reduced linear growth of children. These findings highlight the complex etiology of stunting and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents must be pursued as part of a comprehensive strategy to enhance child growth and development, i.e. improved caretaker capacity, integrated community development, improved parenting skills, as well as reduced gender discrimination, and domestic violence.

scholarly journals Relative importance of prenatal and postnatal determinants of stunting: data mining approaches to the MINIMat cohort, Bangladesh

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025154 ◽  
Author(s):  
Pernilla Svefors ◽  
Oleg Sysoev ◽  
Eva-Charlotte Ekstrom ◽  
Lars Ake Persson ◽  
Shams E Arifeen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parental Education ◽  
Linear Growth ◽  
Infant Nutrition ◽  
Substantial Reduction ◽  
Child Growth ◽  
Conditional Inference ◽  
Household Food Security ◽  
Growth Trajectories ◽  
Relative Importance

IntroductionWHO has set a goal to reduce the prevalence of stunted child growth by 40% by the year 2025. To reach this goal, it is imperative to establish the relative importance of risk factors for stunting to deliver appropriate interventions. Currently, most interventions take place in late infancy and early childhood. This study aimed to identify the most critical prenatal and postnatal determinants of linear growth 0–24 months and the risk factors for stunting at 2 years, and to identify subgroups with different growth trajectories and levels of stunting at 2 years.MethodsConditional inference tree-based methods were applied to the extensive Maternal and Infant Nutrition Interventions in Matlab trial database with 309 variables of 2723 children, their parents and living conditions, including socioeconomic, nutritional and other biological characteristics of the parents; maternal exposure to violence; household food security; breast and complementary feeding; and measurements of morbidity of the mothers during pregnancy and repeatedly of their children up to 24 months of age. Child anthropometry was measured monthly from birth to 12 months, thereafter quarterly to 24 months.ResultsBirth length and weight were the most critical factors for linear growth 0–24 months and stunting at 2 years, followed by maternal anthropometry and parental education. Conditions after birth, such as feeding practices and morbidity, were less strongly associated with linear growth trajectories and stunting at 2 years.ConclusionThe results of this study emphasise the benefit of interventions before conception and during pregnancy to reach a substantial reduction in stunting.

scholarly journals Multilevel analysis of risk factors associated with severe underweight among children under 5 years: evidence from the 2014 Ghana Demographic and Health Survey

2021 ◽  
Vol 2 (1) ◽  
pp. 166-172
Author(s):  
Justice M K Aheto ◽  
Ogum-Alangea Deda
Keyword(s):  
Risk Factors ◽  
Health Survey ◽  
Maternal Education ◽  
Demographic And Health Survey ◽  
Multiple Birth ◽  
Demographic And Health Surveys ◽  
Z Score ◽  
Household Level ◽  
Factors Associated ◽  
Weight For Age

Background: Undernutrition among children <5yr. is a global public health problem, especially in developing countries like Ghana. Undernutrition increases the risk of child morbidity and mortality. There is paucity of data on household-level effects on severe underweight and associated factors. Objective: The study investigated the risk factors associated with severe underweight among children < 5yr.in Ghana and examined unobserved differences across households based on the 2014 Ghana Demographic and Health surveys (GDHS) data. Methods: Data from a population-based cross-sectional study was obtained from the 2014 Ghana Demographic and Health Survey. Data on 2720 children nested within 1972 households was extracted for analysis. Our regression analysis used data on 2716 children with complete data on the outcome and risk factors. Children with weight-for-age Z-score below -3 standard deviations were classified as severely underweight based on the 2006 WHO child growth standards. We applied random intercept multilevel logistic regression to examine whether severe underweight status in children differ across households while simultaneously identifying potential risk factors. Results: A total of 2720 children had valid weight-for-age z-score and 53 (1.95%) of them were identified as severely underweight. In the univariate model, child level variables such as multiple birth [odds ratio (OR), 4.03;95%confidence interval (CI): 1.85-8.76]and child born average (OR, 2.17;95%CI: 1.09-4.32) or small (OR, 4.08; 95%CI: 2.01-8.28) in size at birth are associated with increased odds of severe underweight. Maternal/household level variables such as increase in number of children below 5 yr. (OR, 1.61; 95%CI: 1.28-2.04), poorest households (OR, 4.85; 95%CI: 1.14-20.59) and increase in number of births in last 5 yr. (OR, 1.80, 95%CI: 1.24-2.60) were associated with increased odds of severe underweight. Increase in maternal years of education (OR, 0.89; 95%CI: 0.83-0.95) was associated with reduced odds of severe underweight. In the multilevel logistic model, only type of birth (OR, 1.61;95%CI: 1.28-2.04), size of child (average: OR, 2.12;95%CI: 1.04-4.33; small: OR, 3.87;95%CI: 1.80-8.33) at birth, and maternal education (OR, 0.92;95%CI: 0.84-1.00) were independently associated with severe underweight. There were no significant residual household-level variations in severe underweight status. Conclusion: Our findings suggest that improving maternal education, socioeconomic conditions of families, and family planning are critical in addressing severe underweight

scholarly journals Identifying Faltering of Growth Velocity and Associated Risk Factors Among Preschool Aged Children in Nepal

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 864-864
Author(s):  
Swetha Manohar ◽  
Andrew Thorne-Lyman ◽  
Elizabeth Colantuoni ◽  
K C Angela ◽  
Binod Shrestha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Growth Velocity ◽  
Regression Models ◽  
Linear Growth ◽  
Height Velocity ◽  
Individual Risk ◽  
Z Score ◽  
Poor Growth ◽  
Growth Faltering ◽  
Increased Risk

Abstract Objectives Linear growth failure is often assessed as a height-for-age z-score (HAZ) &lt; −2, which defines stunting. Faltering growth velocity on the other hand reveals a dynamic process, for which improving risk factors could help prevent poor growth, regardless of HAZ. Our aim was to reveal rates and risk factors of growth faltering in Nepali preschool children using a novel linear growth velocity (LGV) reference. Methods We assessed length/height in children under-five from 2013–16 during the same season in 21 wards across the plains (Tarai) of Nepal (n = 4439). Annualized LGVs were calculated from paired measures and stratified into interval-initiating ages of &lt;6, 6–11, 12–23, 24–35, 36–47, 48–59 mo. An annualized, age-sex-specific LGV reference was derived by combining the WHO Growth Standards (for intervals starting &lt;12 mo) and the Tanner Height Velocity Reference (for intervals starting later) using linear restricted cubic spline regression models, from which LGV z-scores (LGVZ) were derived and used to evaluate Nepali child growth. Community, household and individual risk factors were assessed during interval-initiating visits and subjected to multivariable logistic regression models to examine associations with LGVZ &lt; −2 (growth faltering) vs &gt; 2. Results LGV faltering affected 29.8% and 34.8% of boys and girls &lt;24 months, and 6.8% and 7.1% 24–60 months, respectively. Girls were at higher odds of faltering, although 95% CI excluded 1 only for the interval starting at 12–23 mo (OR: 1.77; 95% CI: 1.26, 2.50). Children &lt;24 mo whose weight-for-height z- score was &gt; the WHO median had lower odds of faltering than thinner children (OR: 0.25 - 0.40, all upper 95% CLs &lt; 1). Children of short (&lt;150 cm) mothers had higher odds of faltering, with 95% CIs excluding 1 for interval-initiating ages &lt; 6, 12–23 and 24–35 mo. Above 36 mo, community characteristics such as proximity to market, and access to roads and schools were stronger in their protective growth association than individual or household factors. Conclusions Growth faltering can be assessed across all preschool years by this WHO-Tanner linear growth velocity reference. Nepali children exhibited substantial growth faltering &lt;24 months. Females, children who were thin, and born to short mothers were at an increased risk of growth faltering. Funding Sources USAID, Sight and Life, and Procter & Gamble.

scholarly journals Maternal intake of omega-3 and omega-6 polyunsaturated fatty acids during mid-pregnancy is inversely associated with linear growth

2018 ◽  
Vol 9 (4) ◽  
pp. 432-441 ◽  
Author(s):  
M. Al-Hinai ◽  
A. Baylin ◽  
M. M. Tellez-Rojo ◽  
A. Cantoral ◽  
A. Ettinger ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Polyunsaturated Fatty Acids ◽  
Maternal Education ◽  
Linear Growth ◽  
Second Trimester ◽  
Z Score ◽  
Linear Regression Models ◽  
Alpha Linolenic Acid ◽  
Pufa Intake ◽  
Z Scores

AbstractThis study investigates relations of maternal N-3 and N-6 polyunsaturated fatty acids (PUFA) intake during pregnancy with offspring body mass index (BMI), height z-score and metabolic risk (fasting glucose, C-peptide, leptin, lipid profile) during peripuberty (8–14 years) among 236 mother–child pairs in Mexico. We used food frequency questionnaire data to quantify trimester-specific intake of N-3 alpha-linolenic acid, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); N-6 linoleic acid and arachidonic acid (AA); and N-6:N-3 (AA:EPA+DHA), which accounts for the fact that the two PUFA families have opposing effects on physiology. Next, we used multivariable linear regression models that accounted for maternal education and parity, and child’s age, sex and pubertal status, to examine associations of PUFA intake with the offspring outcomes. In models where BMI z-score was the outcome, we also adjusted for height z-score. We found that higher second trimester intake of EPA, DHA and AA were associated with lower offspring BMI and height z-score. For example, each 1-s.d.increment in second trimester EPA intake corresponded with 0.25 (95% CI: 0.03, 0.47) z-scores lower BMI and 0.20 (0.05, 0.36) z-scores lower height. Accounting for height z-score in models where BMI z-score was the outcome attenuated estimates [e.g., EPA: −0.16 (−0.37, 0.05)], suggesting that this relationship was driven by slower linear growth rather than excess adiposity. Maternal PUFA intake was not associated with the offspring metabolic biomarkers. Our findings suggest that higher PUFA intake during mid-pregnancy is associated with lower attained height in offspring during peripuberty. Additional research is needed to elucidate mechanisms and to confirm findings in other populations.

scholarly journals Prevalence of anemia in under five-year-old children: a hospital-based study

2019 ◽  
Vol 6 (2) ◽  
pp. 842
Author(s):  
Swatantar Singh ◽  
Sangeeta Parihar
Keyword(s):  
Risk Factors ◽  
Maternal Education ◽  
Tertiary Care ◽  
Causative Factor ◽  
Child Growth ◽  
Nutritional Deficiency ◽  
Age Group ◽  
Growth Standards ◽  
Under Five ◽  
Associated Risk Factors

Background: Anemia affects individuals of both gender and all ages, there is a need for localized and age- and context-specific studies to improve our knowledge of prevalence patterns and associated risk factors of Indian population. The present study was done to determine the prevalence of and associated risk factors for anemia in under five-year-old children in a tertiary care teaching hospital.Methods: A prospective observational study was carried out among under five-year-old children suffering from anemia. For the diagnosis of anemia, WHO criteria for haemoglobin (Hb) threshold in different age group were used. The growth and development statuses of children were evaluated by WHO's Child Growth Standards 2006.Results: Total 240 anaemic children were enrolled into the study. Children of age group of between 2-5 years was more affected. A majority of the mother of anaemic children had primary level of school education. More than half of the children belong to lower socioeconomic classes (Class IV + Class V). Nutritional deficiency was the single most important causative factor in the development of anemia. Infectious diseases found to be more prevalent.Conclusions: Nutritional deficiency, particularly, iron deficiency is the leading cause of anemia in the present study. In addition to nutritional deficiency, socioeconomic factors like, gender, maternal education and SE class also play an important role in development of anemia.

scholarly journals Parasite and maternal risk factors for malnutrition in preschool-age children in Belen, Peru using the new WHO Child Growth Standards

2007 ◽  
Vol 98 (6) ◽  
pp. 1259-1266 ◽  
Author(s):  
Martin Casapía ◽  
Serene A. Joseph ◽  
Carmen Núñez ◽  
Elham Rahme ◽  
Theresa W. Gyorkos
Keyword(s):  
Risk Factors ◽  
High Intensity ◽  
Maternal Education ◽  
High Growth ◽  
Child Growth ◽  
Preschool Age ◽  
Maternal Risk ◽  
Growth Standards ◽  
Preschool Age Children ◽  
Maternal Bmi

Child malnutrition, including wasting, underweight and stunting, is associated with infections, poor nutrient intake, and environmental and socio-demographic factors. Preschool-age children are especially vulnerable due to their high growth requirements. To target interventions for preschool-age children in a community of extreme poverty in Peru, we conducted a household survey between October 2005 and January 2006 to determine the prevalence of malnutrition and its risk factors. Of 252 children < 5 years old, the prevalence of wasting, underweight and stunting was 26·6, 28·6 and 32·1 %, respectively, based on the new WHO Child Growth Standards. Risk factors for wasting were: (1) moderate–high intensity Trichuris infection (OR 2·50; 95 % CI 1·06, 5·93); (2) hookworm infection (OR 6·67; 95 % CI 1·08, 41·05); (3) age (OR6-month 1·27; 95 % CI 1·11, 1·46); (4) maternal education (secondary incomplete) (OR 5·77; 95 % CI 2·38, 13·99); and (5) decreasing maternal BMI (OR1 kg/m2 1·12; 95 % CI 1·02, 1·23). Risk factors for underweight were: (1) moderate–high intensity Trichuris infection (OR 4·74; 95 % CI 1·99, 11·32); (2) age (OR6-month 1·22; 95 % CI 1·07, 1·38); (3) maternal education (secondary incomplete) (OR 2·92; 95 % CI 1·40, 6·12); and (4) decreasing maternal BMI (OR1 kg/m2 1·11; 95 % CI 1·02, 1·21). Risk factors for stunting were: (1) age (OR6-month 1·14; 95 % CI 1·02, 1·27) and (2) decreasing maternal height (OR1 cm 1·12; 95 % CI 1·06, 1·20). Overall, risk factors for malnutrition included both child and maternal determinants. Based on these data, locally appropriate and cost-effective dietary, de-worming and educational programmes should be targeted to mothers and preschool-age children.

scholarly journals Concomitant Trajectories of Internalising, Externalising, and Peer Problems Across Childhood: a Person-centered Approach

2021 ◽  
Author(s):  
Lisa-Christine Girard
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Maternal Education ◽  
Group Membership ◽  
Multinomial Logistic Regression ◽  
Problem Domain ◽  
Peer Problems ◽  
Associated Risk Factors ◽  
Person Centered Approach

AbstractThis study investigated trajectories of concomitant internalising, externalising, and peer problems, and associated risk factors for group-membership, using a person-centered approach to better understand heterogeneity in subgroups identified. A cohort of 7,507 children in Ireland was followed from infancy to late childhood (50.3%, males; 84.9% Irish). The parent-version of the Strengths and Difficulties Questionnaire was used when children were 3, 5, 7 and 9 years of age. Information on antecedent risk factors was collected when children were 9 months. Group-based multi-trajectory modelling and multinomial logistic regression were used. Six subgroups of children with distinct profiles were identified, evidencing both homotypic and heterotypic comorbidity. No support of a ‘pure’ internalising, externalising or peer problems group was found in any identified trajectory group. Difficulties in one problem domain indicated the presence of difficulty in another problem domain for all children in elevated groups. Risk factors associated with group-membership were complex, with only three common factors across elevated groups: prenatal exposure to smoking, maternal education, and maternal stress. Specific risk factors for group-membership included low birth weight, sex, maternal age, maternal depression, family composition, social class, medical card status and quality of attachment. Despite some overlap in predictors, the combination of predictors specific to each group would suggest tailored programming. For children with the most acute problems, programming targets should include families with boys, born with low birth weight, exposed to smoking prenatally, with mothers who have lower levels of education, postnatal depression, increased stress and fewer financial resources.

scholarly journals Factors associated with normal linear growth among pre-school children living in better-off households: a multi-country analysis of nationally representative data

2019 ◽  
Author(s):  
Dickson A. Amugsi ◽  
Zacharie T. Dimbuene ◽  
Elizabeth W. Kimani-Murage
Keyword(s):  
School Children ◽  
Normal Child ◽  
Maternal Education ◽  
Linear Growth ◽  
Normal Growth ◽  
Child Growth ◽  
Outcome Variable ◽  
Maternal Weight ◽  
Factors Associated ◽  
Maternal Parity

AbstractThis study examined the factors associated with normal linear growth among pre-school children living in better-off households, using survey data from Ghana, Kenya, Nigeria, Mozambique and Democratic Republic of Congo (DRC). The primary outcome variable was child height-for-age z-scores (HAZ), categorised into HAZ≥-2SD (normal growth/not stunted) and HAZ<–2 (stunted). Using logistic regression, we estimated adjusted odds ratios (aORs) of the factors associated with normal growth. Higher maternal weight (measured by body mass index) was associated with increased odds of normal growth in Mozambique, DRC, Kenya and Nigeria. A unit increase in maternal years of education was associated with increased odds in normal growth in DRC (aOR=1.06, 95% CI=1.03, 1.09), Ghana (aOR=1.08, 95% CI=1.04, 1.12), Mozambique (aOR=1.08, 95% CI=1.05, 1.11) and Nigeria (aOR=1.07, 95% CI=1.06, 1.08). A year increase in maternal age was positively associated with normal growth in all the five countries. Breastfeeding was associated with increased odds of normal growth in Nigeria (aOR= 1.30, 95% CI=1.16, 1.46) and Kenya (aOR=1.37, 95% CI=1.05, 1.79). Children of working mothers had 25% (aOR=0.75, 95% CI=0.60, 0.93) reduced odds of normal growth in DRC. A unit change in maternal parity was associated with 10% (aOR=0.90, 95% CI=0.84, 0.97), 23% (aOR=0.77, 95% CI=0.63, 0.93), 25% (aOR=0.75, 95% CI=0.69, 0.82), 6% (aOR=0.94, 95% CI=0.89, 0.99) and 5% (aOR=0.95, 95% CI=0.92, 0.99) reduced odds of normal growth in DRC, Ghana, Kenya, Mozambique and Nigeria respectively. A child being a male was associated with 16% (aOR=0.82, 95% CI=0.68, 0.98), 40% (aOR=0.60, 95% CI=0.40, 0.89), 37% (aOR=0.63, 95% CI=0.51, 0.77) and 21% (aOR=0.79, 95% CI=0.71, 0.87) reduced odds of normal child growth in DRC, Ghana, Kenya and Nigeria respectively. In conclusion, maternal education, weight, age, breastfeeding and antenatal care are positively associated with normal child growth, while maternal parity, employment, and child sex and age are associated negatively with normal growth. Interventions to improve child growth should take into account these differential effects.

scholarly journals Lifetime economic impact of the burden of childhood stunting attributable to maternal psychosocial risk factors in 137 low/middle-income countries

2019 ◽  
Vol 4 (1) ◽  
pp. e001144 ◽  
Author(s):  
Mary C Smith Fawzi ◽  
Kathryn G Andrews ◽  
Günther Fink ◽  
Goodarz Danaei ◽  
Dana Charles McCoy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Depression ◽  
Psychosocial Factors ◽  
Maternal Education ◽  
Child Growth ◽  
Psychosocial Risk Factors ◽  
Psychosocial Risk ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

IntroductionThe first 1000 days of life is a period of great potential and vulnerability. In particular, physical growth of children can be affected by the lack of access to basic needs as well as psychosocial factors, such as maternal depression. The objectives of the present study are to: (1) quantify the burden of childhood stunting in low/middle-income countries attributable to psychosocial risk factors; and (2) estimate the related lifetime economic costs.MethodsA comparative risk assessment analysis was performed with data from 137 low/middle-income countries throughout Asia, Latin America and the Caribbean, North Africa and the Middle East, and sub-Saharan Africa. The proportion of stunting prevalence, defined as <−2 SDs from the median height for age according to the WHO Child Growth Standards, and the number of cases attributable to low maternal education, intimate partner violence (IPV), maternal depression and orphanhood were calculated. The joint effect of psychosocial risk factors on stunting was estimated. The economic impact, as reflected in the total future income losses per birth cohort, was examined.ResultsApproximately 7.2 million cases of stunting in low/middle-income countries were attributable to psychosocial factors. The leading risk factor was maternal depression with 3.2 million cases attributable. Maternal depression also demonstrated the greatest economic cost at $14.5 billion, followed by low maternal education ($10.0 billion) and IPV ($8.5 billion). The joint cost of these risk factors was $29.3 billion per birth cohort.ConclusionThe cost of neglecting these psychosocial risk factors is significant. Improving access to formal secondary school education for girls may offset the risk of maternal depression, IPV and orphanhood. Focusing on maternal depression may play a key role in reducing the burden of stunting. Overall, addressing psychosocial factors among perinatal women can have a significant impact on child growth and well-being in the developing world.

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