Do socio-economic inequalities in infant growth in rural India operate through maternal size and birth weight?
Do socio-economic inequalities in infant growth in rural India operate through maternal size and birth weight?
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DOI：
10.3109/03014460.2015.1134656
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发表时间：
2016-03-03
影响因子：
1.7
通讯作者：
Johnson, William
中科院分区：
文献类型：
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作者：
Griffiths, Paula L.;Balakrishna, Nagalla;Johnson, William
背景：每年共有310万幼儿死于营养不良。有针对性的干预措施需要更好地了解社会经济地位（SES）与造成营养不良的生物因素之间的联系。目的：通过对母亲和早期婴儿尺寸的测量，确定以12个月时婴儿尺寸为代表的营养不良的SES不平等是否起作用。对象和方法：样本包括2005-2007年在安得拉邦农村60个村庄出生的347名印度婴儿。采用结构方程路径模型，将12月龄年龄z分数（LAZ/WAZ） SES（生活水平指数）与身高、体重的总关系分解为直接路径和间接路径（通过母体BMI和身高、出生体重z分数和6月龄LAZ/WAZ）。结果：SES与12月龄LAZ（标准化系数= 0.08,95% CI = 0.02 ~ 0.13）、WAZ（标准化系数= 0.08,95% CI = 0.02 ~ 0.15）呈正相关。此外，增加母亲身高和随后增加6个月出生体重和WAZ/LAZ也存在间接正相关，分别占WAZ和LAZ总效应的35%和53%。结论：研究结果支持针对母亲最矮的最贫困家庭的婴儿进行基于证据的生长干预。增加SES可以促进两代人的生长。
Background: In total, 3.1 million young children die every year from under-nutrition. Greater understanding of associations between socio-economic status (SES) and the biological factors that shape under-nutrition are required to target interventions.Aim: To establish whether SES inequalities in under-nutrition, proxied by infant size at 12 months, operate through maternal and early infant size measures.Subjects and methods: The sample comprised 347 Indian infants born in 60 villages in rural Andhra Pradesh 2005-2007. Structural equation path models were applied to decompose the total relationship between SES (standard of living index) and length and weight for age Z-scores (LAZ/WAZ) at 12 months into direct and indirect (operating through maternal BMI and height, birthweight Z-score and LAZ/WAZ at 6 months) paths.Results: SES had a direct positive association with LAZ (Standardised coefficient = 0.08, 95% CI = 0.02-0.13) and WAZ at age 12 months (Standardised coefficient = 0.08, 95% CI = 0.02-0.15). It also had additional indirect positive associations through increased maternal height and subsequently increased birthweight and WAZ/LAZ at 6 months, accounting for 35% and 53% of the total effect for WAZ and LAZ, respectively.Conclusion: Findings support targeting evidence based growth interventions towards infants from the poorest families with the shortest mothers. Increasing SES can improve growth for two generations.