Association of maternal and child nutritional status in Brazil: a population based cross-sectional study.
BACKGROUND
Although child undernutrition and stunting has been decreasing worldwide while obesity rates increase, these extreme conditions might coexist in families from low- and middle-income countries. We examined the association between maternal and child anthropometric indicators using a population representative sample.


METHODS
4,258 non-pregnant women and their children <60 months who participated in the 2006 Brazilian Demographic Health Survey. We compared the distributions of two nutritional indexes of children, height-for-age (HAZ) and body mass index-for age (BAZ) z-scores, by categories of maternal height, body mass index (BMI), and waist circumference (WC). Adjusted mean differences and 95% confidence intervals (95% CI) were estimated from linear regression, taking into account the complex survey design. We also examined the associations of maternal anthropometry with the prevalence of child stunting (HAZ<-2) and overweight/obesity (BAZ>2).


RESULTS
HAZ was positively associated with maternal height and WC in a linear fashion. After adjustment, for sociodemographic characteristics, children whose mothers' height was<145 cm had 1.2 lower HAZ than children whose mothers were ≥160 cm tall (p-trend<0.0001). After further adjustment for maternal height and maternal BMI, children of mothers with a waist circumference ≥88 cm had 0.3 higher HAZ than those of mothers with WC<80 cm (p-trend<0.01). Adjusted prevalence ratios and 95% CI for stunting by the categories of maternal height (<145, 145-149, 150-154, 155-159 and ≥160 cm) were, respectively, 2.95 (1.51;5.77), 2.29 (1.33;3.93), 1.09 (0.63;1.87), and 0.89 (0.45;1.77), (p-trend = 0.001). BAZ was positively associated with maternal BMI and WC.


CONCLUSIONS
We observed a strong, positive association of maternal and child nutritional status. Mothers of low stature had children with lower stature, mothers with central obesity had taller children, and mothers with overall or abdominal obesity had children with higher BAZ.
Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
Mariana Santos
MS
Felisbino-Mendes
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
Eduardo
E
Villamor
Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
Gustavo
G
Velasquez-Melendez
D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D001827:Body Height; D001938:Brazil / Q000453:epidemiology; D002664:Child Nutritional Physiological Phenomena / Q000235:genetics; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D040582:Inheritance Patterns; D008297:Male; D009035:Mothers; D009752:Nutritional Status / Q000235:genetics*; D009765:Obesity / Q000453:epidemiology / Q000235:genetics* / Q000378:metabolism / Q000503:physiopathology; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population; D055105:Waist Circumference