Nutrition and Clinical Services Division, icddr,b, Dhaka 1212, Bangladesh.
World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland.
Nutrients. 2022 May 5;14(9):1935. doi: 10.3390/nu14091935.
Malnutrition in women has been a long-standing public health concern, with serious effects on child survival and development. Maternal body mass index (BMI) is an important maternal nutritional indicator. There are few published studies although child anthropometric failures do not occur in isolation and identifying children with single versus several co-occurring failures can better capture cases of growth failure in combination: stunting, wasting, and underweight. In the context of multiple anthropometric failures, traditional markers used to assess children's nutritional status tend to underestimate overall undernutrition. Using the composite index of anthropometric failure (CIAF), we aimed to assess the association between maternal undernutrition and child undernutrition among children with diarrhea under the age of two and to investigate the correlates. Using 1431 mother-child dyads from the Antibiotic for Children with Diarrhea (ABCD) trial, we extracted children's data at enrollment and on day 90 and day 180 follow-ups. ABCD was a randomized, multi-country, multi-site, double-blind, placebo-controlled clinical trial. The Bangladesh site collected data from July 2017 to July 2019. The outcome variable, CIAF, allows combinations of height-for-age, height-for-weight, and weight-for-age to determine the overall prevalence of undernutrition. The generalized estimating equation was used to explore the correlates of CIAF. After adjusting all the potential covariates, maternal undernutrition status was found to be strongly associated with child undernutrition using the CIAF [aOR: 1.4 (95% CI: 1.0, 1.9), -value = 0.043] among the children with diarrhea under 2 years old. Maternal higher education had a protective effect on CIAF [aOR: 0.7 (95% CI: 0.5, 0.9), -value = 0.033]. Our study findings highlight the importance of an integrated approach focusing on maternal nutrition and maternal education could affect a reduction in child undernutrition based on CIAF.
妇女营养不良一直是一个长期存在的公共卫生问题，对儿童的生存和发展有严重影响。母体体重指数（BMI）是一个重要的母体营养指标。尽管儿童的人体测量学失败并非孤立发生，但发表的相关研究很少，确定有单一或多种同时发生的失败的儿童，可能更能捕捉到结合发生的生长失败情况：发育迟缓、消瘦和体重不足。在多种人体测量失败的情况下，用于评估儿童营养状况的传统指标往往会低估整体营养不足。我们使用人体测量失败综合指数（CIAF）来评估营养不良的母亲与 2 岁以下腹泻儿童营养不足之间的关联，并探讨其相关性。利用来自儿童腹泻抗生素试验（ABCD）的 1431 对母婴对，我们提取了儿童在入组时以及 90 天和 180 天随访时的数据。ABCD 是一项随机、多国、多地点、双盲、安慰剂对照的临床试验。孟加拉国站点的数据收集时间为 2017 年 7 月至 2019 年 7 月。结局变量 CIAF 允许身高与年龄、身高与体重和体重与年龄的组合来确定营养不良的整体流行率。广义估计方程用于探索 CIAF 的相关性。在调整了所有潜在的混杂因素后，我们发现，在 2 岁以下腹泻儿童中，母亲的营养不良状况与 CIAF 所代表的儿童营养不良有很强的关联[aOR：1.4（95%CI：1.0，1.9），-值=0.043]。母亲接受较高教育对 CIAF 有保护作用[aOR：0.7（95%CI：0.5，0.9），-值=0.033]。我们的研究结果强调了一种综合方法的重要性，这种方法侧重于母亲的营养和母亲的教育，可能会影响基于 CIAF 的儿童营养不良的减少。
