Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
Department of Economic History, School of Economics and Management, Lund University, Lund, Sweden.
Matern Child Nutr. 2023 Oct;19(4):e13537. doi: 10.1111/mcn.13537. Epub 2023 Jun 5.
Child stunting prevalence is primarily used as an indicator of impeded physical growth due to undernutrition and infections, which also increases the risk of mortality, morbidity and cognitive problems, particularly when occurring during the 1000 days from conception to age 2 years. This paper estimated the relationship between stunting prevalence and age for children 0-59 months old in 94 low- and middle-income countries. The overall stunting prevalence was 32%. We found higher stunting prevalence among older children until around 28 months of age-presumably from longer exposure times and accumulation of adverse exposures to undernutrition and infections. In most countries, the stunting prevalence was lower for older children after around 28 months-presumably mostly due to further adverse exposures being less detrimental for older children, and catch-up growth. The age for which stunting prevalence was the highest was fairly consistent across countries. Stunting prevalence and gradient of the rise in stunting prevalence by age varied across world regions, countries, living standards and sex. Poorer countries and households had a higher prevalence at all ages and a sharper positive age gradient before age 2. Boys had higher stunting prevalence but had peak stunting prevalence at lower ages than girls. Stunting prevalence was similar for boys and girls after around age 45 months. These results suggest that programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence. Importantly, however, since some catch-up growth may be achieved after age 2, screening around this time can be beneficial.
儿童发育迟缓的患病率主要用作因营养不良和感染导致身体生长受阻的指标，这也增加了死亡率、发病率和认知问题的风险，尤其是在受孕到 2 岁期间的 1000 天内。本文估计了 94 个低收入和中等收入国家 0-59 个月大儿童发育迟缓患病率与年龄的关系。总体发育迟缓患病率为 32%。我们发现，年龄较大的儿童发育迟缓的患病率更高，直到大约 28 个月龄，这可能是由于较长的暴露时间和累积的营养不良和感染不良暴露。在大多数国家，28 个月龄后，年龄较大的儿童发育迟缓的患病率较低，这可能主要是因为进一步的不良暴露对年龄较大的儿童的危害性较小，并且可以追赶生长。发育迟缓患病率最高的年龄在各国之间相当一致。发育迟缓患病率和年龄增长的斜率在世界各地区、国家、生活水平和性别之间存在差异。较贫穷的国家和家庭在所有年龄段的患病率都较高，在 2 岁之前，正斜率更为陡峭。男孩的发育迟缓患病率较高，但比女孩更早达到峰值。2 岁以后，男孩和女孩的发育迟缓患病率相似。这些结果表明，预防营养不良和感染的方案应重点关注年龄较小的儿童，以优化减少发育迟缓患病率的效果。然而，重要的是，由于在 2 岁后可能会出现一些追赶生长，因此在这个时候进行筛查可能是有益的。
