title: Adult consequences of growth failure in early childhood.
abstract: BACKGROUND
  Growth failure is associated with adverse consequences, but studies need to control adequately for confounding.
  
  
  OBJECTIVE
  We related height-for-age z scores (HAZs) and stunting at age 24 mo to adult human capital, marriage, fertility, health, and economic outcomes.
  
  
  METHODS
  In 2002-2004, we collected data from 1338 Guatemalan adults (aged 25-42 y) who were studied as children in 1969-1977. We used instrumental variable regression to correct for estimation bias and adjusted for potentially confounding factors.
  
  
  RESULTS
  A 1-SD increase in HAZ was associated with more schooling (0.78 grades) and higher test scores for reading and nonverbal cognitive skills (0.28 and 0.25 SDs, respectively), characteristics of marriage partners (1.39 y older, 1.02 grade more schooling, and 1.01 cm taller) and, for women, a higher age at first birth (0.77 y) and fewer number of pregnancies and children (0.63 and 0.43, respectively). A 1-SD increase in HAZ was associated with increased household per capita expenditure (21%) and a lower probability of living in poverty (10 percentage points). Conversely, being stunted at 2 y was associated with less schooling, a lower test performance, a lower household per capita expenditure, and an increased probability of living in poverty. For women, stunting was associated with a lower age at first birth and higher number of pregnancies and children. There was little relation between either HAZ or stunting and adult health.
  
  
  CONCLUSIONS
  Growth failure in early life has profound adverse consequences over the life course on human, social, and economic capital.
authors.affiliation: Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC (JH and ARQ); the Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA (JRB); the Department of Economics, Middlebury College, Middlebury, VT (JAM); The Institute of Nutrition of Central America and Panama, Guatemala City, Republic of Guatemala (PM and MR-Z); and the Hubert Department of Global Health, Rollins School of Public Health (ADS, KMY, and RM), and the Department of Sociology (KMY), Emory University, Atlanta, GA.
authors.forename: John
authors.initials: J
authors.lastname: Hoddinott
authors.forename: Jere R
authors.initials: JR
authors.lastname: Behrman
authors.forename: John A
authors.initials: JA
authors.lastname: Maluccio
authors.forename: Paul
authors.initials: P
authors.lastname: Melgar
authors.forename: Agnes R
authors.initials: AR
authors.lastname: Quisumbing
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramirez-Zea
authors.forename: Aryeh D
authors.initials: AD
authors.lastname: Stein
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Yount
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Martorell
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D001827:Body Height / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005183:Failure to Thrive / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000453:epidemiology*; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D008297:Male; D011203:Poverty; D016032:Randomized Controlled Trials as Topic