母亲身高与中低收入国家母婴死亡率、低体重儿和发育迟缓的关联。
Association of maternal stature with offspring mortality, underweight, and stunting in low- to middle-income countries.
机构信息
Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA.
出版信息
JAMA. 2010 Apr 21;303(15):1507-16. doi: 10.1001/jama.2010.450.
CONTEXT
Although maternal stature has been associated with offspring mortality and health, the extent to which this association is universal across developing countries is unclear.
OBJECTIVE
To examine the association between maternal stature and offspring mortality, underweight, stunting, and wasting in infancy and early childhood in 54 low- to middle-income countries.
DESIGN, SETTING, AND PARTICIPANTS: Analysis of 109 Demographic and Health Surveys in 54 countries conducted between 1991 and 2008. Study population consisted of a nationally representative cross-sectional sample of children aged 0 to 59 months born to mothers aged 15 to 49 years. Sample sizes were 2,661,519 (mortality), 587,096 (underweight), 558,347 (stunting), and 568,609 (wasting) children.
MAIN OUTCOME MEASURES
Likelihood of mortality, underweight, stunting, or wasting in children younger than 5 years.
RESULTS
The mean response rate across surveys in the mortality data set was 92.8%. In adjusted models, a 1-cm increase in maternal height was associated with a decreased risk of child mortality (absolute risk difference [ARD], 0.0014; relative risk [RR], 0.988; 95% confidence interval [CI], 0.987-0.988), underweight (ARD, 0.0068; RR, 0.968; 95% CI, 0.968-0.969), stunting (ARD, 0.0126; RR, 0.968; 95% CI, 0.967-0.968), and wasting (ARD, 0.0005; RR, 0.994; 95% CI, 0.993-0.995). Absolute risk of dying among children born to the tallest mothers (> or = 160 cm) was 0.073 (95% CI, 0.072-0.074) and to those born to the shortest mothers (< 145 cm) was 0.128 (95% CI, 0.126-0.130). Country-specific decrease in the risk for child mortality associated with a 1-cm increase in maternal height varied between 0.978 and 1.011, with the decreased risk being statistically significant in 46 of 54 countries (85%) (alpha = .05).
CONCLUSION
Among 54 low- to middle-income countries, maternal stature was inversely associated with offspring mortality, underweight, and stunting in infancy and childhood.
背景
尽管母体身高与后代的死亡率和健康状况有关，但这种关联在发展中国家是否普遍存在尚不清楚。
目的
在 54 个中低收入国家中，研究母体身高与后代在婴儿期和幼儿期的死亡率、体重不足、发育迟缓以及消瘦之间的关系。
设计、地点和参与者：对 1991 年至 2008 年间在 54 个国家进行的 109 次人口与健康调查进行了分析。研究人群由年龄在 15 至 49 岁之间的母亲所生的 0 至 59 个月大的具有全国代表性的横断面样本儿童组成。样本量分别为 2661519 名（死亡率）、587096 名（体重不足）、558347 名（发育迟缓）和 568609 名（消瘦）儿童。
主要观察指标
5 岁以下儿童的死亡率、体重不足、发育迟缓或消瘦的可能性。
结果
在死亡率数据集的调查中，平均应答率为 92.8%。在调整后的模型中，母亲身高每增加 1 厘米，儿童死亡的风险就会降低（绝对风险差异[ARD]，0.0014；相对风险[RR]，0.988；95%置信区间[CI]，0.987-0.988），体重不足（ARD，0.0068；RR，0.968；95% CI，0.968-0.969），发育迟缓（ARD，0.0126；RR，0.968；95% CI，0.967-0.968）和消瘦（ARD，0.0005；RR，0.994；95% CI，0.993-0.995）。出生于最高母亲（>或= 160 厘米）的儿童死亡的绝对风险为 0.073（95% CI，0.072-0.074），而出生于最矮母亲（<145 厘米）的儿童死亡的绝对风险为 0.128（95% CI，0.126-0.130）。与母亲身高每增加 1 厘米相关的儿童死亡率风险的国家特异性降低幅度在 0.978 至 1.011 之间变化，其中 46 个（85%）国家（α=0.05）的风险降低具有统计学意义。
结论
在 54 个中低收入国家中，母体身高与后代在婴儿期和儿童期的死亡率、体重不足和发育迟缓呈负相关。
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