Abstract
Objective: Estimate the risk of linear growth retardation during the first two years of life as a result of household social vulnerability.
Setting: Families who participated in the National Supplementary Feeding Program in the Health Units of the metropolitan area of the city of São Paulo, Brazil.
Subjects: Four hundred and thirty-one index-babies, weighing more than 2500 grams and who had at least one young sibling under the age of five who participated in the Program for a minimum of two years.
Design: The index-babies were divided into two cohorts: 74.9% coming from ‘non-stunted families’ (those with normal height siblings) and 25.1% from ‘stunted families’ (those with stunted siblings). The study design allowed the observation of growth patterns over a period of time and over a childhood growth range. It also allowed the estimation of the stunting and the recovery probabilities at each moment, not only within a given age range. The transition probabilities between ‘stunted’ and ‘non-stunted’ index-babies were estimated. The relative risk ratio (RR) was also calculated.
Results: The prevalence of stunting in the index-babies at 12 and 24 months of age was significantly greater in ‘stunted families’ P<0.001). Probabilities of becoming stunted began to differ from the fourth month on (confidence intervals non-superposed), and were higher for index-babies from ‘stunted families’. The recovery probability of a stunted child was smaller in the ‘stunted families’ cohort after the 12th month of age. From the third month on, the (RR) was always above 1.5.
Conclusion: The family context exposes children to failure in growth in the first two years of life when there are already stunted children in the household.
Sponsorship: Brazilian National Research Council (CNPq Nos 300977/90-5 and 5209115/97-6).
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Contributors: Doris LM Lei planned and developed the study design, and was the study coordinator. Adrianna B Ribeiro and Renata D Friere collected the data. Maria ML Escuder was responsible for management data and Ångela T Paes did all the statistical analysis. Doris LM Lei, Sandra P Chaves and Barbara R Lerner wrote the manuscript, and, together with Ångela T Paes, revised the paper.
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Lei, D., Chaves, S., Paes, A. et al. Risk of linear growth retardation during the first two years of life: a new approach. Eur J Clin Nutr 53, 456–460 (1999). https://doi.org/10.1038/sj.ejcn.1600776
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DOI: https://doi.org/10.1038/sj.ejcn.1600776