title: Higher maternal education is associated with favourable growth of young children in different countries.
abstract: BACKGROUND
  Childhood growth affects long-term health and could contribute to health inequalities that persist throughout life.
  
  
  METHODS
  We compared growth data of 4-year-old to 6-year-old children born 1997-2002 in UK (n=15,168), Sweden (n=6749) and rural China (n=10,327). SD scores (SDS) were calculated against the WHO Growth Standard. Obesity and overweight were defined by the International Obesity Taskforce cut-offs, and stunting, underweight and thinness by height, weight or body mass index (BMI)<-2 SDS. Associations with maternal education were standardised by calculating the Slope Index of Inequality (SII).
  
  
  RESULTS
  Mean SDS height, weight and BMI in the UK (-0.01, 0.42, 0.62, respectively) and Sweden (0.45, 0.59, 0.45) were higher than in China (-0.98, -0.82, -0.29). Higher maternal education was consistently associated with taller offspring height SDS (SII: UK 0.25; Sweden 0.17; China 1.06). Underweight and stunting were less common in the UK (prevalence: 0.6% and 2.2%, respectively) and Sweden (0.3% and 0.6%) than in China (9.5% and 16.4%), where these outcomes were inversely associated with maternal education (SII: -25.8% and -12.7%). Obesity prevalence in the UK, Sweden and China was 4.8%, 3.7% and 0.4%, respectively. Maternal education was inversely associated with offspring obesity in the UK (SII: -3.3%) and Sweden (-2.8%), but not in China (+0.3%).
  
  
  CONCLUSIONS
  Higher maternal education was associated with more favourable growth in young children: lower obesity and overweight in the UK and Sweden, and lower stunting and underweight in rural China. Public health strategies to optimise growth in early childhood need to acknowledge socioeconomic factors, but possibly with a different emphasis in different settings.
authors: MRC Epidemiology Unit, Addenbrookes Hospital, Cambridge, UK.
authors: Rajalakshmi
authors: R
authors: Lakshman
authors: Jing
authors: J
authors: Zhang
authors: Jianduan
authors: J
authors: Zhang
authors: Felix S
authors: FS
authors: Koch
authors: Claude
authors: C
authors: Marcus
authors: Johnny
authors: J
authors: Ludvigsson
authors: Ken K
authors: KK
authors: Ong
authors: Tanja
authors: T
authors: Sobko
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D002648:Child; D002657:Child Development / Q000502:physiology*; D015362:Child Nutrition Disorders / Q000453:epidemiology; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D057238:Growth Charts; D006130:Growth Disorders / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009035:Mothers / Q000193:education* / Q000523:psychology; D012424:Rural Population; D013548:Sweden / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: GROWTH; INEQUALITIES; NUTRITION; OBESITY; PUBLIC HEALTH