Risk of linear growth retardation during the first two years of life: a new approach.
OBJECTIVE
Estimate the risk of linear growth retardation during the first two years of life as a result of household social vulnerability.


METHODS
Families who participated in the National Supplementary Feeding Program in the Health Units of the metropolitan area of the city of São Paulo, Brazil.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Division of Nutrition Research, Institute of Health, São Paulo, Brazil. doris@isaude.sp.gov.br
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D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005190:Family; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011203:Poverty; D015995:Prevalence; D012306:Risk; D012931:Social Environment; D014505:Urban Population