Wu Han, Ma Chuanwei, Yang Liu, Xi Bo
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Nutr. 2021 Aug 11;8:650976. doi: 10.3389/fnut.2021.650976. eCollection 2021.
Maternal height has been confirmed to be associated with offspring stunting in low- and middle-income countries (LMICs), but only limited studies have examined the paternal-offspring association, and few studies have examined the joint effect of maternal and paternal height on stunting. To investigate the association between parental height and stunting of children aged under five in LMICs. We obtained data from the Demographic and Health Surveys (DHS) conducted in 14 LMICs from 2006 to 2016. The association between maternal and paternal height and height-for-age score (HAZ) of children aged under five was analyzed using a linear regression model in consideration of complex survey design, and regression coefficients (β) with 95% confidence intervals (CIs) were reported. Then, the association between maternal and paternal height quintile and child stunting was analyzed using a modified Poisson regression approach with robust error variance in consideration of complex survey design with adjustment for covariates. The effect estimates were expressed as relative risks (RRs) with 95% CIs. A total of 50,372 singleton children were included and the weighted prevalence of stunting was 34.5%. Both maternal height and paternal height were associated with child HAZ (β = 0.047; 95% CI, 0.043, 0.050; and β = 0.022; 95% CI, 0.018, 0.025, respectively). Compared with those born to the tallest mothers and fathers, children from the shortest mothers and the shortest fathers had higher risks of stunting (adjusted RR = 1.89; 95% CI, 1.78, 2.01; adjusted RR = 1.56; 95% CI, 1.47, 1.65, respectively). The mother-offspring associations are substantively larger than the father-offspring associations for each corresponding height quintile. Children from the shortest parents had the highest risk of stunting compared with children from the tallest parents (adjusted RR = 3.23; 95% CI, 2.83, 3.68). Offspring born to short parents are at increased risk of stunting in LMICs, and this intergenerational effect is partly driven by maternal intrauterine influence. This suggests the importance of improving the nutritional status of children and adults in LMICs, especially female caregivers.
在低收入和中等收入国家（LMICs），母亲身高已被证实与子代发育迟缓有关，但仅有有限的研究考察了父亲与子代的关联，且很少有研究探讨母亲和父亲身高对发育迟缓的联合影响。为了调查LMICs中父母身高与5岁以下儿童发育迟缓之间的关联。我们从2006年至2016年在14个LMICs进行的人口与健康调查（DHS）中获取数据。考虑到复杂的调查设计，使用线性回归模型分析母亲和父亲身高与5岁以下儿童年龄别身高得分（HAZ）之间的关联，并报告回归系数（β）及其95%置信区间（CIs）。然后，考虑到复杂的调查设计并对协变量进行调整，使用具有稳健误差方差的修正泊松回归方法分析母亲和父亲身高五分位数与儿童发育迟缓之间的关联。效应估计值以相对风险（RRs）及其95% CIs表示。总共纳入了50372名单胎儿童，发育迟缓的加权患病率为34.5%。母亲身高和父亲身高均与儿童HAZ相关（β分别为0.047；95% CI，0.043，0.050；以及β为0.022；95% CI，0.018，0.025）。与父母身高最高的孩子相比，父母身高最矮的孩子发育迟缓风险更高（调整后的RR = 1.89；95% CI，1.78，2.01；调整后的RR = 1.56；95% CI，1.47，1.65）。在每个相应的身高五分位数中，母婴关联实质上大于父子关联。与父母身高最高的孩子相比，父母身高最矮孩子的发育迟缓风险最高（调整后的RR = 3.23；95% CI，2.83，3.68）。在LMICs中，父母身高矮的子代发育迟缓风险增加，这种代际效应部分由母亲的子宫内影响驱动。这表明在LMICs中改善儿童和成人，尤其是女性照料者的营养状况的重要性。
