Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- to Middle-Income Countries

Abstract

Maternal stature is an important determinant of intrauterine growth restriction¹ and low birth weight,² especially in developing countries. Low birth weight and intrauterine growth restriction are predictors of subsequent mortality and growth failure.³ Because attained height reflects the health stock accumulated through social and environmental exposures during early childhood,^4,5 maternal stature is a simple, stable, and useful marker for assessing intergenerational linkages in health. Maternal stature has been shown to predict offspring outcomes before or immediately after birth.⁶ However, evidence for whether risks associated with shorter maternal stature have a lasting influence on the offspring's health during infancy and childhood is limited, or is restricted to small nonrepresentative samples, and inconclusive. In a large, nationally representative data set from India, an inverse association between maternal stature and both child mortality and growth failure was observed.⁷ It remains unclear the extent to which this association is present across a wider range of countries. Using the largest available, nationally representative, and comparable sample from 109 surveys in 54 low- to middle-income countries, with objective measurements of maternal stature and offspring anthropometry, we investigated the potential long-term effects of maternal stature on offspring mortality, underweight, stunting, and wasting in infancy and early childhood.