Maternal Undernutrition Indicators as Proxy Indicators of Their Offspring’s Undernutrition: Evidence from 2011 Ethiopia Demographic and Health Survey.
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Date
2016
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Addis Abeba Universty
Abstract
Background: The intergenerational continuity of under nutrition 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 child rennutrition status.
Objective: To examine whether maternal under nutrition indicators can be used as a proxyindicator of their offspring’s under nutrition.
Methods: Data were obtained from the 2011 Ethiopia Demographic and Health Survey (EDHS2011). 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 under nutrition indicators are less informative in predicting their offspring’s under nutrition, 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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Keywords
Maternal, Undernutrition Indicators ,Proxy Indicators