Estimating the pathways through which maternal education affects stunting

Evidence from an urban cohort in South Africa

Bibliographic Data

ID15094358
AuthorsDaniela Casale (0000-0003-1337-1196, University of the Witwatersrand, corresponding author), Gabriel Espi-Sanchis (0000-0002-9365-5326, University of the Witwatersrand), Gabriel Espi, Shane A Norri (0000-0001-7124-3788, University of the Witwatersrand), Shane A Norris
Year2018
Volume21
Issue10
Pages1810-1818
Publication date2018-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980018000125
PMID29455701
OpenAlexW2792633350
LanguageEN
Citations received8
References cited31

Objective To estimate the determinants of stunting using rich data from a birth cohort study from urban South Africa and to examine the various mechanisms, both proximate and distal, through which maternal education affects stunting. Design Multivariate regression analysis using birth cohort data, where the outcome variable was stunting at age 2 years, and multiple mediator analysis to identify pathways from maternal education to stunting. Setting South Africa’s largest metropolitan area, Soweto-Johannesburg. Subjects Participants of Birth to Twenty Plus, a longitudinal cohort study of children born in 1990 ( n 691). Results In multivariate analysis, the birth weight Z -score (−0·084; P P =0·04; 95 % CI −0·10, −0·00), and a better-quality care environment (−0·015; P =0·04; 95 % CI −0·03, −0·00) were found to be negatively associated with stunting. Having experienced symptoms of illness related to ears and eyes increased the risk of stunting (0·038; P =0·01; 95 % CI 0·01, 0·07). Results of the mediation analysis showed that maternal education had an indirect effect on stunting largely through socio-economic status and the antenatal environment (measured by the birth weight Z -score). Conclusions Overall, many of the factors that were protective against stunting in the final analysis, whether they operated through maternal education or not, were related to the mother’s contribution to the child’s life. This reinforces the idea that to minimise stunting, enhanced antenatal and postnatal services to better support and empower mothers may be important

Biology · Birth weight · Cohort · Cohort study · Environmental health · Low birth weight · Multivariate analysis · Pregnancy · Child Nutrition and Water Access · Climate Change and Health Impacts · Demography · Energy and Environment Impacts · Medicine · Internal Medicine · Pediatrics

Tools

Open DOISci-HubOpen Access