Comparative models of biological and social pathways to predict child growth through age 2 years from birth cohorts in Brazil, India, the Philippines, and South Africa

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dc.contributor.author Richter, Linda M.
dc.contributor.author Orkin, F Mark
dc.contributor.author Roman, Gabriela D.
dc.contributor.author Dahly, Darren L.
dc.contributor.author Horta, Bernardo L.
dc.contributor.author Bhargava, Santosh K.
dc.contributor.author Norris, Shane A.
dc.contributor.author Stein, Aryeh D.
dc.date.accessioned 2019-09-09T11:50:27Z
dc.date.available 2019-09-09T11:50:27Z
dc.date.issued 2018-07-13
dc.identifier.citation Richter, L.M., Orkin, F.M., Roman, G.D., Dahly, D.L., Horta, B.L., Bhargava, S.K., Norris, S.A., Stein, A.D. and COHORTS investigators, 2018. Comparative Models of Biological and Social Pathways to Predict Child Growth through Age 2 Years from Birth Cohorts in Brazil, India, the Philippines, and South Africa. The Journal of nutrition, 148(8). (8pp). DOI:10.1093/jn/nxy101 en
dc.identifier.volume 148 en
dc.identifier.issued 8 en
dc.identifier.startpage 1364 en
dc.identifier.endpage 1371 en
dc.identifier.issn 0022-3166
dc.identifier.uri http://hdl.handle.net/10468/8477
dc.identifier.doi 10.1093/jn/nxy101 en
dc.description.abstract Background: Early growth faltering accounts for one-third of child deaths, and adversely impacts the health and human capital of surviving children. Social as well as biological factors contribute to growth faltering, but their relative strength and interrelations in different contexts have not been fully described. Objective: The aim of this study was to use structural equation modelling to explore social and biological multidetermination of child height at age 2 y in longitudinal data from 4 birth cohort studies in low- and middle-income countries. Methods: We analyzed data from 13,824 participants in birth cohort studies in Brazil, India, the Philippines, and South Africa. We used exploratory structural equation models, with height-for-age at 24 mo as the outcome to derive factors, and path analysis to estimate relations among a wide set of social and biological variables common to the 4 sites. Results: The prevalence of stunting at 24 mo ranged from 14.0% in Brazil to 67.7% in the Philippines. Maternal height and birthweight were strongly predictive of height-for-age at 24 mo in all 4 sites (all P values <0.001). Three social-environmental factors, which we characterized as “child circumstances,” “family socioeconomic status,” and “community facilities,” were identified in all sites. Each social-environmental factor was also strongly predictive of height-for-age at 24 mo (all P values <0.001), with some relations partly mediated through birthweight. The biological pathways accounted for 59% of the total explained variance and the social-environmental pathways accounted for 41%. The resulting path coefficients were broadly similar across the 4 sites. Conclusions: Early child growth faltering is determined by both biological and social factors. Maternal height, itself a marker of intergenerational deprivation, strongly influences child height at 2 y, including indirect effects through birthweight and social factors. However, concurrent social factors, many of which are modifiable, directly and indirectly contribute to child growth. This study highlights opportunities for interventions that address both biological and social determinants over the long and short term. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Oxford University Press en
dc.relation.uri https://academic.oup.com/jn/article/148/8/1364/5053831
dc.rights © 2018 American Society for Nutrition en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Infant en
dc.subject Growth failure en
dc.subject Birth cohort en
dc.subject Structural equation modeling en
dc.subject Longitudinal model en
dc.subject Social en
dc.subject Environmental en
dc.subject Biological en
dc.title Comparative models of biological and social pathways to predict child growth through age 2 years from birth cohorts in Brazil, India, the Philippines, and South Africa en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Darren Dahly, HRB Clinical Research Facility, University College Cork, Cork, Ireland. +353-21-490-3000 Email: ddahly@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Bill and Melinda Gates Foundation en
dc.contributor.funder Wellcome Trust en
dc.contributor.funder Indian Council of Medical Research en
dc.contributor.funder US National Center for Health Statistics en
dc.contributor.funder Medical Research Council (UK) en
dc.contributor.funder British Heart Foundation en
dc.contributor.funder NIH (US) en
dc.contributor.funder Human Sciences Research Council en
dc.contributor.funder South African Medical Research Council en
dc.contributor.funder University of the Witwatersrand, Johannesburg en
dc.contributor.funder DST-NRF Centre of Excellence in Human Development en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Nutrition en
dc.internal.IRISemailaddress ddahly@ucc.ie en
dc.identifier.eissn 1541-6100


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