Combined effect of short stature and socioeconomic status on body mass index and weight gain during reproductive age in Brazilian women

Abstract

Short stature, a marker for undernutrition early in life, has been associated with obesity in Brazilian women, but not in men. We tested the hypothesis that weight gain during the reproductive years could explain this gender difference. A national two-stage household survey of mothers with one or more children under five years of age was conducted in Brazil in 1996. The subjects were women aged 20 to 45 years (N = 2297), with last delivery seven months or more prior to the interview. The regions of the country were divided into rural, North/ Northeast (urban underdeveloped) and South/Southeast/Midwest (urban developed). The dependent variables were current body mass index (BMI) measured, BMI prior to childbearing (reported), and BMI change. Socioeconomic variables included mother's years of education and family purchasing power score. A secondary analysis was restricted to primiparous women. The prevalence of current overweight and overweight prior to childbearing (BMI ≥25 kg/m 2 ) was higher among shorter women (<1.50 m) compared to normal stature women only in the urban developed region (P < 0.05). After adjustment for socioeconomic variables, age, parity, BMI prior to childbearing, and age at first birth, current BMI was 2.39 units higher (P = 0.008) for short stature women living in the urban developed area compared with short stature women living in the urban underdeveloped area. For both multiparous and primiparous women, BMI gain compared to the value prior to childbearing was significantly higher among short stature women living in the urban developed region (P ≤ 0.04). These results provide clear evidence that short stature was associated with a higher BMI and with an increased risk of weight gain/retention with pregnancy in the developed areas of Brazil, but not in the underdeveloped ones.

Associação entre desnutrição em crianças moradoras de favelas, estado nutricional materno e fatores socioambientais

“…Within this context, height deficits observed inside the uterus and/or in the early childhood could determine the short height of adults. 9,24,25 In the present study, most mothers were short, which is also found in other studies with populations that were subjected to chronic hunger, determining the cycle of childhood malnutrition, short height, obesity, and comorbidities in adulthood. [26][27][28] At present, we also demonstrated that statistically, regardless of the nutritional status of mothers, shorter height was directly associated with child malnutrition.…”

Association between malnutrition in children living in slums, maternal nutritional status, and environmental factors

“…Segundo Ong 23 , o baixo peso ao nascer, associado à introdução tardia de alimentos complementares e a uma maior incidência de diarreia, favorecidos pela insalubridade do meio ambiente, pode determinar a alta prevalência de desnutrição observada em populações menos favorecidas, como as de nosso estudo. Dentro desse contexto, déficits estaturais observados intrauterinamente e/ou na primeira infância poderiam determinar a baixa estatura dos adultos 9,24,25 . 0 = informantes com condição menos favorável e/ou menor/igual em relação ao ponto de corte definido a priori ; 1 = informantes com condição mais favorável e/ou igual/ maior em relação ao ponto de corte também definido a priori ; IMC = índice de massa corporal; RC = razão de chances ajustada para "peso da criança ao nascer".…”

Anthropometric assessment of nutritional status in Brazilian pregnant women

“…The major increase in BMI after pregnancy among low-stature women in urban areas, independent of parity, clearly demonstrates the risk of a higher gestational weight gain and its retention after delivery in the most developed areas in the country (42).…”

“…Because low stature is a marker of previous malnutrition, it is important to ensure adequate gestational weight for low-stature women (42). On the other hand, among these cases, excessive weight may be associated with cephalopelvica disproportion (11,27,28).…”