Are Stunted Child/Overweight Mother Pairs a Distinct Entity or a Statistical Artifact? Demographic and Health Surveys, 1991-2009. Open Access

Abstract

Stunted child/overweight mother pairs [SCOWT] have been viewed as a distinct entity, and much effort has been put forth to characterize the environments that create these dual burden households. We hypothesize that the prevalence of SCOWT pairs is not independent of the prevalence of overweight mothers and stunted children in the general population.

We analyzed data from the Demographic and Health Surveys from 1991-2009 for this secondary data analysis. Datasets were included if the maternal BMI and the height-for-age z-scores for children were reported. Mothers were included if they had a living child between two and five years old and were not currently pregnant.

Of 1,708,688 households in 131 datasets, 339,202 households met inclusion criteria. The median prevalence of maternal overweight, childhood stunting and SCOWT pairs was 19.6% (range 1.6%-70.7%), 27.3% (range 6.65%-50.8%), 3.3% (range 0.5%-16.0%), respectively. The mean difference between the observed and expected prevalence of SCOWT pairs was -1.18% (95% CI -1.32%, -1.04%). Only two datasets had an observed prevalence of SCOWT pairs that was higher than the expected prevalence. SCOWT prevalence was more strongly associated with maternal overweight than with child stunting. We found that the prevalence of SCOWT pairs is dependent primarily on the prevalence of maternal overweight.

Table of Contents

Table of Contents Background.........................................................................1 Literature Review.................................................................10 Methods.............................................................................11 Results...............................................................................14 Discussion..........................................................................16 Strengths and Limitations.......................................................17 Public Health Importance and Policy Implications.........................18 Future Directions..................................................................20 References........................................................................22 Tables and Figures.............................................................24 Table 1: Results of Literature Review........................................24

Table 2: Prevalence of Maternal Overweight, Childhood Stunting, and Observed and Expected Prevalence of SCOWT Pairs in 121 DHS datasets...27

Figure 1: Relationship of Maternal Overweight and SCOWT Prevalences...31

Figure 2: Relationship of Childhood Stunting and SCOWT Prevalences...32

Figure 3: Relationship Between Prevalence of Childhood Stunting and Maternal Overweight...33

Figure 4: Prevalence of SCOWT Pairs in Relation to Maternal Overweight and Childhood Stunting...34

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	dual-burden Demographic and Health Surveys childhood stunting maternal overweight
Committee Chair / Thesis Advisor	Stein, Aryeh D, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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