Early childhood stunting; evidence from a prospective birth cohort in rural Kenya
1
Health and Demographic Surveillance System, Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, Nairobi, Kenya
Popul. Med. 2026;8(Supplement Supplement 1):A2117
ABSTRACT
ABSTRACT:
Background and Aims Timing of onset of early childhood stunting is not well defined, despite being critical for implementing interventions for preventing stunting and enabling catch-up growth. This study aimed to examine growth patterns of infants in their first year to establish the age of stunting onset and its predictors.
METHODS:
A prospective birth cohort was established within a rural setting in Kenya. Baseline data including household food insecurity data and infant’s weight and length at birth was recorded at enrollment. Children were followed-up monthly for 13 months for growth monitoring and maternal dietary diversity assessed three months postpartum. Length-for-age Z-scores (LAZ) were computed using WHO 2006 growth standards. Time to onset of stunting was determined using survival analysis. Cox proportional hazards model was used to establish predictors of stunting.
RESULTS:
A total of 790 newborns were registered into the cohort. At delivery, only 3.4% of the newborn’s households had experienced severe hunger. About 47.7% of the mothers had recommended diet diversity at 3 months postpartum. Mean monthly LAZ ranged from -0.98 to -0.12. The mean age of onset of stunting was 2.4 months. By approximately 2 months of age, about 50% of the infants were already stunted, rising to about 75% by the age of 2.9 months. In the cox proportional hazard model, male infants (aHR = 1.54, 95% CI 1.14–2.06) had significantly higher hazard of stunting while normal length at birth (aHR = 0.70, 95% CI 0.51–0.96) and maternal dietary diversity score of greater than 5 food groups (aHR = 0.61, 95% CI 0.41–0.93) reduced the hazard of stunting.
CONCLUSIONS:
Stunting occurred early in infancy in this population. The risk of stunting was influenced by the infant’s condition at birth and maternal nutrition practices. Stunting was therefore modulated by nutritional practices, with potential in-utero onset.
Background and Aims Timing of onset of early childhood stunting is not well defined, despite being critical for implementing interventions for preventing stunting and enabling catch-up growth. This study aimed to examine growth patterns of infants in their first year to establish the age of stunting onset and its predictors.
METHODS:
A prospective birth cohort was established within a rural setting in Kenya. Baseline data including household food insecurity data and infant’s weight and length at birth was recorded at enrollment. Children were followed-up monthly for 13 months for growth monitoring and maternal dietary diversity assessed three months postpartum. Length-for-age Z-scores (LAZ) were computed using WHO 2006 growth standards. Time to onset of stunting was determined using survival analysis. Cox proportional hazards model was used to establish predictors of stunting.
RESULTS:
A total of 790 newborns were registered into the cohort. At delivery, only 3.4% of the newborn’s households had experienced severe hunger. About 47.7% of the mothers had recommended diet diversity at 3 months postpartum. Mean monthly LAZ ranged from -0.98 to -0.12. The mean age of onset of stunting was 2.4 months. By approximately 2 months of age, about 50% of the infants were already stunted, rising to about 75% by the age of 2.9 months. In the cox proportional hazard model, male infants (aHR = 1.54, 95% CI 1.14–2.06) had significantly higher hazard of stunting while normal length at birth (aHR = 0.70, 95% CI 0.51–0.96) and maternal dietary diversity score of greater than 5 food groups (aHR = 0.61, 95% CI 0.41–0.93) reduced the hazard of stunting.
CONCLUSIONS:
Stunting occurred early in infancy in this population. The risk of stunting was influenced by the infant’s condition at birth and maternal nutrition practices. Stunting was therefore modulated by nutritional practices, with potential in-utero onset.
| eISSN: | 2654-1459 |
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