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      Early-life Determinants of Stunted Adolescent Girls and Boys in Matlab, Bangladesh

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          Abstract

          This paper presents the results of a longitudinal study, conducted in Matlab, Bangladesh, that examined to what extent the level of stunting in adolescence can be predicted by nutritional status in early childhood and maternal height. A linked set of data collected from the same individuals at two moments in time, i.e. early childhood (1988–1989) and adolescence (2001), was analyzed. The study found that the odds of being stunted in adolescence could be explained by the combined effect of being stunted in childhood and having a mother whose height was less than 145 cm. Also, girls were more likely than boys to be stunted in childhood, whereas boys were more likely than girls to be stunted in adolescence. The latter is probably attributable to differences in the pace of maturation. In terms of policy and (reproductive health) programmes, it is important to recall that adolescent girls whose height and weight were subnormal (weight <45 kg and height <145 cm) might run an obstetric risk. Following these cut-off points, 83% and 23% of 16-year-old girls in this study would face obstetric risk, respectively, for weight and height if they marry and become pregnant soon.

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          Most cited references47

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          Reversibility of stunting: epidemiological findings in children from developing countries.

          The growth literature from developing countries is reviewed to assess the extent to which stunting, a phenomenon of early childhood, can be reversed in later childhood and adolescence. The potential for catch-up growth increases as maturation is delayed and the growth period is prolonged. However, maturational delays in developing countries are usually less than two years, only enough to compensate for a small fraction of the growth retardation of early childhood. Follow-up studies find that subjects who remain in the setting in which they became stunted experience little or no catch-up in growth later in life. Improvements in living conditions, as through food supplementation or through adoption, trigger catch-up growth but do so more effectively in the very young. One study cautions that in older adopted subjects, accelerated growth may accelerate maturation, shorten the growth period and lead to short adult stature.
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            Intrauterine growth and gestational duration determinants.

            Despite the general recognition that low birth weight can be caused by many factors, confusion and controversy remain about which factors have independent causal effects, as well as the quantitative importance of those effects. Previous research findings have often been conflicting because of a failure to distinguish intrauterine growth retardation from prematurity, differences in focus (means v rates), inadequate control for confounding variables, and insufficient statistical power. This review of the English and French language medical literature published between 1970 and 1984 is based on a critical assessment and meta-analysis of 895 studies concerning 43 potential determinants of intrauterine growth or gestational duration. Based on methodologic standards established a priori for each candidate determinant, the best studies were used to assess the existence and magnitude of an independent causal effect on birth weight, gestational age, prematurity, and intrauterine growth retardation. Factors with well-established direct causal impacts are identified, and their relative importance is indicated for "typical" developing and developed country settings. Modifiable factors with large effects are targeted for public health intervention in the two settings. Finally, factors of potential quantitative importance, but for which data are either unavailable or inconclusive, are highlighted as priorities for future research.
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              Fetal experience and good adult design.

              P. Bateson (2001)
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                Author and article information

                Journal
                J Health Popul Nutr
                JHPN
                Journal of Health, Population, and Nutrition
                International Centre for Diarrhoeal Disease Research, Bangladesh
                1606-0997
                June 2008
                : 26
                : 2
                : 189-199
                Affiliations
                [1] 1Department of Population and Development, Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
                [2] 2Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E8138, Baltimore, MD, USA
                [3] 3ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh
                Author notes

                Correspondence and reprint requests should be addressed to: Dr. Alinda Bosch, Netherlands Interdisciplinary Demographic Institute, Lange Houtstraat 19, 2511 CV The Hague, The Netherlands, Email: bosch@ 123456nidi.nl , Fax: +31 70 3647187

                Article
                jhpn0026-0189
                2740662
                18686552
                2f4f7e34-1b98-42c8-91cc-746dffb01d63
                © INTERNATIONAL CENTRE FOR DIARRHOEAL DISEASE RESEARCH, BANGLADESH

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Original Papers

                Nutrition & Dietetics
                longitudinal studies,anthropometry,maternal height,stunting,infant growth,adolescence,nutritional status,bangladesh

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