TY - JOUR
T1 - Early-childhood linear growth faltering in low- and middle-income countries
AU - The Ki Child Growth Consortium
AU - Benjamin-Chung, Jade
AU - Mertens, Andrew
AU - Colford, John M.
AU - Hubbard, Alan E.
AU - van der Laan, Mark J.
AU - Coyle, Jeremy
AU - Sofrygin, Oleg
AU - Cai, Wilson
AU - Nguyen, Anna
AU - Pokpongkiat, Nolan N.
AU - Djajadi, Stephanie
AU - Seth, Anmol
AU - Jilek, Wendy
AU - Jung, Esther
AU - Chung, Esther O.
AU - Rosete, Sonali
AU - Hejazi, Nima
AU - Malenica, Ivana
AU - Li, Haodong
AU - Hafen, Ryan
AU - Subramoney, Vishak
AU - Häggström, Jonas
AU - Norman, Thea
AU - Brown, Kenneth H.
AU - Christian, Parul
AU - Arnold, Benjamin F.
AU - Abbeddou, Souheila
AU - Adair, Linda S.
AU - Ahmed, Tahmeed
AU - Ali, Asad
AU - Ali, Hasmot
AU - Ashorn, Per
AU - Bahl, Rajiv
AU - Barreto, Mauricio L.
AU - Begín, France
AU - Bessong, Pascal Obong
AU - Bhan, Maharaj Kishan
AU - Bhandari, Nita
AU - Bhargava, Santosh K.
AU - Bhutta, Zulfiqar A.
AU - Black, Robert E.
AU - Bodhidatta, Ladaporn
AU - Carba, Delia
AU - Gonzalez Casanova, Ines
AU - Checkley, William
AU - Crabtree, Jean E.
AU - Dewey, Kathryn G.
AU - Duggan, Christopher P.
AU - Fall, Caroline H.D.
AU - Sadiq, Kamran
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/9/21
Y1 - 2023/9/21
N2 - Globally, 149 million children under 5 years of age are estimated to be stunted (length more than 2 standard deviations below international growth standards) 1,2. Stunting, a form of linear growth faltering, increases the risk of illness, impaired cognitive development and mortality. Global stunting estimates rely on cross-sectional surveys, which cannot provide direct information about the timing of onset or persistence of growth faltering—a key consideration for defining critical windows to deliver preventive interventions. Here we completed a pooled analysis of longitudinal studies in low- and middle-income countries (n = 32 cohorts, 52,640 children, ages 0–24 months), allowing us to identify the typical age of onset of linear growth faltering and to investigate recurrent faltering in early life. The highest incidence of stunting onset occurred from birth to the age of 3 months, with substantially higher stunting at birth in South Asia. From 0 to 15 months, stunting reversal was rare; children who reversed their stunting status frequently relapsed, and relapse rates were substantially higher among children born stunted. Early onset and low reversal rates suggest that improving children’s linear growth will require life course interventions for women of childbearing age and a greater emphasis on interventions for children under 6 months of age.
AB - Globally, 149 million children under 5 years of age are estimated to be stunted (length more than 2 standard deviations below international growth standards) 1,2. Stunting, a form of linear growth faltering, increases the risk of illness, impaired cognitive development and mortality. Global stunting estimates rely on cross-sectional surveys, which cannot provide direct information about the timing of onset or persistence of growth faltering—a key consideration for defining critical windows to deliver preventive interventions. Here we completed a pooled analysis of longitudinal studies in low- and middle-income countries (n = 32 cohorts, 52,640 children, ages 0–24 months), allowing us to identify the typical age of onset of linear growth faltering and to investigate recurrent faltering in early life. The highest incidence of stunting onset occurred from birth to the age of 3 months, with substantially higher stunting at birth in South Asia. From 0 to 15 months, stunting reversal was rare; children who reversed their stunting status frequently relapsed, and relapse rates were substantially higher among children born stunted. Early onset and low reversal rates suggest that improving children’s linear growth will require life course interventions for women of childbearing age and a greater emphasis on interventions for children under 6 months of age.
UR - http://www.scopus.com/inward/record.url?scp=85171279236&partnerID=8YFLogxK
U2 - 10.1038/s41586-023-06418-5
DO - 10.1038/s41586-023-06418-5
M3 - Article
C2 - 37704719
AN - SCOPUS:85171279236
SN - 0028-0836
VL - 621
SP - 550
EP - 557
JO - Nature
JF - Nature
IS - 7979
ER -