Intrauterine growth restriction, social circumstances, maternal depression and toddler stunting — A population-based prospective study

Abstract

Objective: the main aim of this article is to analyse differences in childhood growth retardation in relation to intrauterine growth restriction, paying particular attention to social circumstances across income tertiles, the mother’s educational level and maternal depression, in a cohort of Uruguayan infants followed from birth up to three years and eleven. Methods: we used secondary data of pediatric anthropometric measurements and health and socioeconomic characteristics of families which were included in a longitudinal and prospective nationally representative survey (ENDIS, for its acronym in Spanish). The associations of low birth weight (LBW) and small for gestational age (SGA) and being stunted were tested by relative risks (RR). Additionally, we employed multivariate binary logistic regression models to evaluate the effect of birth weight on childhood stunting, adjusting for relevant covariates. Results: the prevalence of stunting was 6.9 % in the first measurement, decreasing by 2 % in the second measurement. The RR for the relation between stunting and LBW or SGA in the second round was 1.06 (95 % CI: 1.01-1.11). The highest prevalence of stunting was observed among children with LBW from lower-income households. Maternal education and depression did not yield statistically significant differences for stunting in the multivariate regression models. Conclusions: our findings suggest that ensuring optimal birth weight and increasing household income represent the first step towards primary prevention of childhood stunting.