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.authorRichter, Linda M.
dc.contributor.authorOrkin, F Mark
dc.contributor.authorRoman, Gabriela D.
dc.contributor.authorDahly, Darren L.
dc.contributor.authorHorta, Bernardo L.
dc.contributor.authorBhargava, Santosh K.
dc.contributor.authorNorris, Shane A.
dc.contributor.authorStein, Aryeh D.
dc.contributor.funderBill and Melinda Gates Foundationen
dc.contributor.funderWellcome Trusten
dc.contributor.funderIndian Council of Medical Researchen
dc.contributor.funderUS National Center for Health Statisticsen
dc.contributor.funderMedical Research Council (UK)en
dc.contributor.funderBritish Heart Foundationen
dc.contributor.funderNIH (US)en
dc.contributor.funderHuman Sciences Research Councilen
dc.contributor.funderSouth African Medical Research Councilen
dc.contributor.funderUniversity of the Witwatersrand, Johannesburgen
dc.contributor.funderDST-NRF Centre of Excellence in Human Developmenten
dc.date.accessioned2019-09-09T11:50:27Z
dc.date.available2019-09-09T11:50:27Z
dc.date.issued2018-07-13
dc.description.abstractBackground: 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationRichter, 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/nxy101en
dc.identifier.doi10.1093/jn/nxy101en
dc.identifier.eissn1541-6100
dc.identifier.endpage1371en
dc.identifier.issn0022-3166
dc.identifier.issued8en
dc.identifier.journaltitleJournal of Nutritionen
dc.identifier.startpage1364en
dc.identifier.urihttps://hdl.handle.net/10468/8477
dc.identifier.volume148en
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urihttps://academic.oup.com/jn/article/148/8/1364/5053831
dc.rights© 2018 American Society for Nutritionen
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectInfanten
dc.subjectGrowth failureen
dc.subjectBirth cohorten
dc.subjectStructural equation modelingen
dc.subjectLongitudinal modelen
dc.subjectSocialen
dc.subjectEnvironmentalen
dc.subjectBiologicalen
dc.titleComparative models of biological and social pathways to predict child growth through age 2 years from birth cohorts in Brazil, India, the Philippines, and South Africaen
dc.typeArticle (peer-reviewed)en
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