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Background: The intergenerational continuity of undernutrition is influenced by shared genetic,
household socio-economic and cultural resources which will be associated with the mother and
the child nutritional status, possibly to the same degree. Provided that this assumption is valid,
assessing maternal nutritional status will provide an effective screening tool for their children
nutrition status.
Objective: To examine whether maternal undernutrition indicators can be used as a proxy
indicator of their offspring’s undernutrition.
Methods: Data were obtained from the 2011 Ethiopia Demographic and Health Survey (EDHS
2011). An analytical sample of 8,505 children whose mothers are not pregnant and live with their
biological mothers was included. The bivariate associations between nutritional indices of the
mother and the children were analyzed with Pearson correlation coefficients. The sensitivity,
specificity, predictive values and area under Roc curves were calculated. We performed ROC
regression analysis to determine factor that affects the accuracy of maternal underweight as a
screening tool. We further performed rocreg postestimation to determine where exactly the test
performed best.
Results: Mean BMI of mothers with stunted children was 20.01 (95% CI: 19.86–20.16), whereas
that mothers with no stunted children was 20.46 (95% CI: 20.31– 20.62). Similarly, children who
experienced underweight or wasting had mothers who had consistently lower BMI than those
who did not (p <0.001). The sensitivity of maternal underweight (defined by BMI < 18.5 kg/m2)
as a predictor of child’s nutritional status (<-2 z-scores) is low, failing to reach 50% for any of the
child nutrition indices. In the roc regression analysis, maternal BMI(<18.5 kg/m2) became a more
accurate predictor of wasting among children whose mother are older (β = -0.014, p=0.002) and
higher parity(β= -0.035, p <0.001), and among children who are not currently breastfeeding (β=
-0.042, p = 0.006) and from richer households (β= -0.037, p <0.001).
Conclusion: Our study provides evidence that maternal undernutrition indicators are less
informative in predicting their offspring’s undernutrition, although maternal BMI (<18.5kg/m2)
may be a better measure of wasting among children whose mothers gave birth to four children
and among children from richest households. |
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