Relative importance of prenatal and postnatal determinants of stunting: data mining approaches to the MINIMat cohort, Bangladesh

Abstract

IntroductionWHO 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 appropriate interventions. Currently, most interventions take place in late infancy and early childhood. This study aimed to identify the most critical prenatal and postnatal determinants of linear growth 0–24 months and the risk factors for stunting at 2 years, and to identify subgroups with different growth trajectories and levels of stunting at 2 years.MethodsConditional inference tree-based methods were applied to the extensive Maternal and Infant Nutrition Interventions in Matlab trial database with 309 variables of 2723 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 measurements 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.ResultsBirth length and weight were the most critical factors for linear growth 0–24 months and stunting at 2 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 2 years.ConclusionThe results of this study emphasise the benefit of interventions before conception and during pregnancy to reach a substantial reduction in stunting.

The effect of nutrition and reproductive health education intervention on pregnant women in reducing stunting in Indonesia: A-quasi experimental study

“…Furthermore, the proper knowledge and the dietary practices simultaneously in uence gestational weight gain, degrade the risk of anemia in the last trimester of pregnancy, improved the baby's birth weight, and reduce the risk of preterm birth [46]. This study strengthens scienti c evidence that nutrition and reproductive health education during pregnancy improved the knowledge, attitude, and practices of pregnant women, which contribute to increased maternal and neonatal health and reduce childhood stunting [29,30,47,48].…”

Child Electronic Growth Monitoring System: An innovative and sustainable approach for establishing the Kaduna Infant Development (KID) Study in Nigeria

“…Our tool has shown how epidemiological and health informatics col- natal trajectories of both weight and length/height. 46 The electronic growth surveillance system would aid the identification of sensitive periods during early childhood growth and development for the screening and mitigation of stunting and obesity. [47][48][49] CEGROMS could also be efficiently and effectively scaled-up at sub-national and national levels for growth surveillance.…”

Regional Disparities of Stunted Toddler in Indonesia

“…Married mothers tend to have better mental states [21][22] because the mother can share the burden and role with her husband. A better parental process will reduce the risk of fives being stunted [23][24][25].…”