Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Effect of maternal and child factors on stunting: partial least squares structural equation modeling

  • Received : 2021.01.27
  • Accepted : 2021.04.27
  • Published : 2022.02.15
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Abstract

Background: Stunting is affected by various factors from mother and child. Previous studies assessed only one or more influencing variables. Unfortunately, nor the significant influence of maternal and child factors nor the indicators contributing to maternal and child factors that affect the stunting incidence have ever been analyzed. Purpose: This study analyzed the effect of maternal and child factors on stunting and the significant indicators that shape the maternal and child factors that impact stunting. Methods: This was a case-control study. Overall, 132 stunted children and 132 nonstunted children in Purbalingga Regency, Central Java Province, participated in the research. Direct interviews and medical record reviews were conducted to assess the studied variables. The research data were tested using the partial least squares structural equation with a formative model. Results: Maternal factors directly affected the occurrence of stunting (t=3.527, P<0.001) with an effect of 30.3%. Maternal factors also contributed a significant indirect effect on stunting through child factors (t=4.762, P<0.001) with an effect of 28.2%. Child factors affected the occurrence of stunting (t=5.749, P<0.001) with an effect of 49.8%. The child factor was influenced by maternal factor with an effect of 56.7% (t=10.014, P<0.001). The moderation analysis results demonstrated that maternal and child factors were moderate predictive variables of stunting occurrence. Conclusion: Child factors have more significant and direct effects on stunting than maternal factors but are greatly affected by them.

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References

  1. Woldehanna T, Behrman JR, Araya MW. The effect of early childhood stunting on children's cognitive achievements: evidence from young lives Ethiopia. Ethiop J Heal Dev 2017;31:75-84.
  2. Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health 2014;34:250-65. https://doi.org/10.1179/2046905514Y.0000000158
  3. Alam MA, Richard SA, Fahim SM, Mahfuz M, Nahar B, Das, S, et al. Impact of early-onset persistent stunting on cognitive development at 5 years of age: results from a multi-country cohort study. PLoS One 2020;15:e0227839. https://doi.org/10.1371/journal.pone.0227839
  4. Fadare O, Amare M, Mavrotas G, Akerele D, Ogunniyi A. Mother's nutrition-related knowledge and child nutrition outcomes: empirical evidence from Nigeria. PLoS One 2019;14:e0212775. https://doi.org/10.1371/journal.pone.0212775
  5. Wemakor A, Garti H, Azongo T, Garti H, Atosona A. Young maternal age is a risk factor for child undernutrition in Tamale Metropolis, Ghana. BMC Res Notes 2018;11:877. https://doi.org/10.1186/s13104-018-3980-7
  6. Jonah CMP, Sambu WC, May JD. A comparative analysis of socioeconomic inequities in stunting: a case of three middle-income African countries. Arch Public Health 2018;76:77. https://doi.org/10.1186/s13690-018-0320-2
  7. Young MF, Nguyen PH, Casanova IG, Addo OY, Tran LM, Nguyen S, et al. Role of maternal preconception nutrition on offspring growth and risk of stunting across the first 1000 days in Vietnam: a prospective cohort study. PLoS One 2018;13:e0203201. https://doi.org/10.1371/journal.pone.0203201
  8. Adams Waldorf KM, McAdams RM. Influence of infection during pregnancy on fetal development. Reproduction 2013;146:R151-62. https://doi.org/10.1530/REP-13-0232
  9. Titaley CR, Ariawan I, Hapsari D, Muasyaroh A, Dibley MJ. Determinants of the stunting of children under two years old in Indonesia: a multilevel analysis of the 2013 Indonesia Basic Health Survey. Nutrients 2019;11:1106. https://doi.org/10.3390/nu11051106
  10. Sania A, Spiegelman D, Rich-Edwards J, Hertzmark E, Mwiru RS, Kisenge R et al. The contribution of preterm birth and intrauterine growth restriction to childhood undernutrition in Tanzania. Matern Child Nutr 2015;11:618-30. https://doi.org/10.1111/mcn.12123
  11. Mikawati, Lusiana E, Hasriany. The relationship between exclusive breastfeeding (ASI) and mother height with incident rates stunting among child age 2-5 years in Barombong Public Health Center, Gowa, Sulawesi Selatan. KnE Life Sciences 2019;4:558-67.
  12. Dewey KG, Mayers DR. Early child growth: how do nutrition and infection interact? Matern Child Nutr 2011;7 Suppl 3:129-42. https://doi.org/10.1111/j.1740-8709.2011.00357.x
  13. Wolf EJ, Harrington KM, Clark SL, Miller MW. Sample size requirements for structural equation models: an evaluation of power, bias, and solution propriety. Educ Psychol Meas 2013;76:913-34.
  14. Wang MJ, Lin HM, Hung LC, Lo YT. Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study. BMC Med Inform Decis Mak 2020;20:74. https://doi.org/10.1186/s12911-020-1095-2
  15. Waddimba AC, Beckman HB, Mahoney TL, Burgess JFJ. The moderating effect of job satisfaction on physicians' motivation to adhere to financially incentivized clinical practice guidelines. Med Care Res Rev 2017;74:148-77. https://doi.org/10.1177/1077558716628354
  16. Garson GD. Partial least squares: regression & structural equation models. Asheboro (NC): Statistical Associates Publishing, 2016.
  17. Desai S, Alva S. Maternal education and child health: is there a strong causal relationship? Demography 1998;35:71-81. https://doi.org/10.2307/3004028
  18. Habimana S, Biracyaza E. Risk factors of stunting among children under 5 years of age in the Eastern and Western provinces of Rwanda: analysis of Rwanda demographic and health survey 2014/2015. Pediatr Heal Med Ther 2019;10:115-30.
  19. Mahanta LB, Roy TD, Dutta RG, Devi A. Nutritional status and the impact of socioeconomic factors on pregnant women in Kamrup district of Assam. Ecol Food Nutr 2012;51:463-80. https://doi.org/10.1080/03670244.2012.705701
  20. Woldeamanuel GG, Geta TG, Mohammed TP, Shuba MB, Bafa TA. Effect of nutritional status of pregnant women on birth weight of newborns at Butajira Referral Hospital, Butajira, Ethiopia. SAGE Open Med 2019;7:2050312119827096. https://doi.org/10.1177/2050312119827096
  21. Baschieri A, Machiyama K, Floyd S, Dube A, Molesworth A, Chihana M, et al. Unintended childbearing and child growth in Northern Malawi. Matern Child Health J 2017;21:467-74. https://doi.org/10.1007/s10995-016-2124-8
  22. Upadhyay AK, Srivastava S. Effect of pregnancy intention, postnatal depressive symptoms and social support on early childhood stunting: findings from India. BMC Pregnancy Childbirth 2016;16:107. https://doi.org/10.1186/s12884-016-0909-9
  23. Rana MJ, Gautam A, Goli S, Uttamacharya, Reja T, Nanda P, et al. Planning of births and maternal, child health, and nutritional outcomes: recent evidence from India. Public Health 2019;169:14-25. https://doi.org/10.1016/j.puhe.2018.11.019
  24. Brantsaeter AL, Olafsdottir AS, Forsum E, Olsen SF, Thorsdottir I. Does milk and dairy consumption during pregnancy influence fetal growth and infant birthweight? A systematic literature review. Food Nutr Res 2012;56:10.3402/fnr.v56i0.20050.
  25. Nisar YB, Dibley MJ, Aguayo VM. Iron-folic acid supplementation during pregnancy reduces the risk of stunting in children less than 2 years of age: a retrospective cohort study from Nepal. Nutrients 2016;8:67. https://doi.org/10.3390/nu8020067
  26. Stephen G, Mgongo M, Hussein Hashim T, Katanga J, Stray-Pedersen B, Msuya SE. Anaemia in pregnancy: prevalence, risk factors, and adverse perinatal outcomes in Northern Tanzania. Anemia 2018;2018:1846280. https://doi.org/10.1155/2018/1846280
  27. Bari A, Sultana N, Mehreen S, Sadaqat N, Imran I, Javed R. Patterns of maternal nutritional status based on mid upper arm circumference. Pakistan J Med Sci 2020;36:382-6.
  28. Ververs M tesse, Antierens A, Sackl A, Staderini N, Captier V. Which anthropometric indicators identify a pregnant woman as acutely malnourished and predict adverse birth outcomes in the humanitarian context? PLoS Curr 2013;5:ecurrents.dis.54a8b618c1bc031ea140e3f2934599c8.
  29. Monte S, Valenti O, Giorgio E, Renda E, Hyseni E, Faraci M, et al. Maternal weight gain during pregnancy and neonatal birth weight: a review of the literature. J Prenat Med 2011;5:27-30.
  30. Petry CJ, Ong KK, Beardsall K, Hughes IA, Acerini CL, Dunger DB. Vomiting in pregnancy is associated with a higher risk of low birth weight: a cohort study. BMC Pregnancy Childbirth 2018;18:133. https://doi.org/10.1186/s12884-018-1786-1
  31. Rahman MS, Mushfiquee M, Masud MS, Howlader T. Association between malnutrition and anemia in under-five children and women of reproductive age: evidence from Bangladesh Demographic and Health Survey 2011. PLoS One 2019;14:e0219170. https://doi.org/10.1371/journal.pone.0219170
  32. Hviid A, Melbye M. The impact of birth weight on infectious disease hospitalization in childhood. Am J Epidemiol 2007;165:756-61. https://doi.org/10.1093/aje/kwk064
  33. Collins A, Weitkamp JH, Wynn JL. Why are preterm newborns at increased risk of infection? Arch Dis Child Fetal Neonatal Ed 2018;103:F391-4. https://doi.org/10.1136/archdischild-2017-313595
  34. Henderickx JGE, Zwittink RD, van Lingen RA, Knol J, Belzer C. The preterm gut microbiota: an inconspicuous challenge in nutritional neonatal care. Front Cell Infect Microbiol 2019;9:85. https://doi.org/10.3389/fcimb.2019.00085
  35. Quigley MA, Carson C, Sacker A, Kelly Y. Exclusive breastfeeding duration and infant infection. Eur J Clin Nutr 2016;70:1420-7. https://doi.org/10.1038/ejcn.2016.135
  36. World Health Organization. Essential nutrition actions: improving maternal, newborn, infant and young child health and nutrition. Geneva (Switzerland): World Health Organization, 2013.
  37. Bardosono S, Sastroamidjojo S, Lukito W. Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia. Asia Pac J Clin Nutr 2007;16:512-26.