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      Maternal Height and Child Growth Patterns


      , PhD 1 , , , PhD 1 , , DM 2 , , PhD 3 , , PhD 4 , , PhD 3 , , PhD 5 , , PhD 6 , , PhD 7 , , MBBS 8 , , PhD 7 , , MD 9 , , PhD 1 , Consortium on Health Orientated Research in Transitional Societies (COHORTS) Group

      The Journal of Pediatrics


      COHORTS, Consortium on Health Orientated Research in Transitional Societies, HAZ, Height-for-age z-scores, LMICs, Low- and middle-income countries, MC, Mid-childhood, MI, Multiple imputations, PR, Prevalence ratio, SES, Socioeconomic status

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          To examine associations between maternal height and child growth during 4 developmental periods: intrauterine, birth to age 2 years, age 2 years to mid-childhood (MC), and MC to adulthood.

          Study design

          Pooled analysis of maternal height and offspring growth using 7630 mother–child pairs from 5 birth cohorts (Brazil, Guatemala, India, the Philippines, and South Africa). We used conditional height measures that control for collinearity in height across periods. We estimated associations between maternal height and offspring growth using multivariate regression models adjusted for household income, child sex, birth order, and study site.


          Maternal height was associated with birth weight and with both height and conditional height at each age examined. The strongest associations with conditional heights were for adulthood and 2 years of age. A 1-cm increase in maternal height predicted a 0.024 (95% CI: 0.021-0.028) SD increase in offspring birth weight, a 0.037 (95% CI: 0.033-0.040) SD increase in conditional height at 2 years, a 0.025 (95% CI: 0.021-0.029 SD increase in conditional height in MC, and a 0.044 (95% CI: 0.040-0.048) SD increase in conditional height in adulthood. Short mothers (<150.1 cm) were more likely to have a child who was stunted at 2 years (prevalence ratio = 3.20 (95% CI: 2.80-3.60) and as an adult (prevalence ratio = 4.74, (95% CI: 4.13-5.44). There was no evidence of heterogeneity by site or sex.


          Maternal height influences offspring linear growth over the growing period. These influences likely include genetic and non-genetic factors, including nutrition-related intergenerational influences on growth that prevent the attainment of genetic height potential in low- and middle-income countries.

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          Most cited references 26

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          Anthropometric measurement error and the assessment of nutritional status.

          Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group of population under investigation. R > 0.95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.
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            Association of maternal stature with offspring mortality, underweight, and stunting in low- to middle-income countries.

            Although maternal stature has been associated with offspring mortality and health, the extent to which this association is universal across developing countries is unclear. 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. 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. Likelihood of mortality, underweight, stunting, or wasting in children younger than 5 years. 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). Among 54 low- to middle-income countries, maternal stature was inversely associated with offspring mortality, underweight, and stunting in infancy and childhood.
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              The effect of physical height on workplace success and income: preliminary test of a theoretical model.

               T Judge,  M Cable (2004)
              In this article, the authors propose a theoretical model of the relationship between physical height and career success. We then test several linkages in the model based on a meta-analysis of the literature, with results indicating that physical height is significantly related to measures of social esteem (rho =.41), leader emergence (rho =.24), and performance (rho =.18). Height was somewhat more strongly related to success for men (rho =.29) than for women (rho =.21), although this difference was not significant. Finally, given that almost no research has examined the relationship between individuals' physical height and their incomes, we present four large-sample studies (total N = 8,590) showing that height is positively related to income (beta =.26) after controlling for sex, age, and weight. Overall, this article presents the most comprehensive analysis of the relationship of height to workplace success to date, and the results suggest that tall individuals have advantages in several important aspects of their careers and organizational lives. (c) 2004 APA

                Author and article information

                J Pediatr
                J. Pediatr
                The Journal of Pediatrics
                1 August 2013
                August 2013
                : 163
                : 2
                : 549-554.e1
                [1 ]Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
                [2 ]Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
                [3 ]Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
                [4 ]Center for Research on Ageing, University of Southampton, Southampton, United Kingdom
                [5 ]Department of Anthropology, Northwestern University, Evanston, IL
                [6 ]Office of Population Studies Foundation, University of San Carlos, Cebu, Philippines
                [7 ]Medical Research Council/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, South Africa and Human Sciences Research Council, Johannesburg, South Africa
                [8 ]Public Health Foundation of India, New Delhi, India
                [9 ]Department of Pediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi, India
                Author notes
                []Reprint requests: O. Yaw Addo, PhD, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Mailstop: 1599-001-BX (SPH GH), 1599 Clifton Road NE, Atlanta, GA 30322. Yaw.addo@ 123456emory.edu

                List of members of the COHORTS Group is available at www.jpeds.com ( Appendix 1).

                © 2013 Mosby, Inc.

                This document may be redistributed and reused, subject to certain conditions.

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