The relative importance of pre- and postnatal determinants of stunting. : Data mining approaches to the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort, Bangladesh

• Background The WHO has set a goal to reduce the prevalence of stunted child growth by 40% by the year 2025. To reach this goal, it is imperative to establish the relative importance of risk factors for stunting to deliver the appropriate interventions. Currently, most interventions take place in late infancy and early childhood. This study aimed to identify the most critical pre- and postnatal determinants of linear growth 0–24 months and the risk factors for stunting at two years, and to identify subgroups with different growth trajectories and levels of stunting at two years.Method and Findings Conditional inference-tree-based methods were applied to the extensive Maternal and Infant Nutrition Interventions in Matlab (MINIMat) trial database with 309 variables of 2,723 children: their parents and living conditions, including socioeconomic, nutritional and other biological characteristics of the parents; maternal exposure to violence; household food security; breast- and complementary-feeding; and measurement of morbidity of the mothers during pregnancy and repeatedly of their children up to 24 months of age. Child anthropometry was measured monthly from birth to 12 months, thereafter quarterly to 24 months. Birth length and weight were the most critical factors for linear growth 0–24 months and stunting at two years, followed by maternal anthropometry and parental education. Conditions after birth, such as feeding practices and morbidity, were less strongly associated with linear growth trajectories and stunting at two years.Interpretation The results of this study, together with findings from recent reviews, motivate a change in policy and practice, emphasizing the benefit of interventions before conception and during pregnancy to reach a substantial reduction in stunting.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

Stunting

nutrition

undernutrition

pre and postnatal interventions

data mining

decision tree

risk factors

Medicinsk vetenskap

Medical Science

Publikations- och innehållstyp

vet (ämneskategori)

ovr (ämneskategori)