ESPE Yearbook of Paediatric Endocrinology

AIMS Public Health 2020; 7(2): 380–392. doi: 10.3934/publichealth.2020032

– Pakistan has a significantly higher prevalence of stunted children under 5 years old compared with other countries of the same income level. Stunting is more frequent in children of shorter compared to taller mothers– The authors hypothesized that higher maternal education, a modifiable factor, is associated with decreased stunting in children of shorter mothers– However, in this cross-sectional study, they found no significant difference in the marginal effect of maternal education on stunting among mothers with different statures

Malnutrition can lead to: (i) stunting (low-height-for-age); (ii) underweight (low-weight-for-age); (iii) wasting (low weight for height), and (iv) overweight (high weight-for-height). Stunting is a predictor of poor future human capital and of undesirable health outcomes. First, the authors found that mothers with short stature have a higher prevalence of stunting, wasted, underweight, and overweight children as compared to taller mothers. Second, they found that the higher prevalence of stunting, wasted, underweight, and overweight among under-five children were associated with mothers of low education level, poor socioeconomic status, and short maternal stature. However, there was no significant interaction effect between maternal education and maternal stature on children’s growth. This suggests that although maternal education has a positive effect on child growth, the role of education is similar across maternal statures. It is reassuring to see that, in a country where > 50% of mothers have no education (partly because 24.3% live below the poverty line), maternal education is an important factor in the growth trajectory of the children across the board, independently from maternal height. According to the Developmental Origins of Health and Disease (DOHaD) theory, adverse nutritional settings in pregnancy may lead to many diseases in adulthood. Therefore, correction of undernutrition (stunting and wasting) and over-nutrition (overweight and obesity) in childhood can prevent adult disease.

This study suggests that a global improvement of maternal education will have a positive effect on the prevention of adult diseases in their children but that this social measure should be implemented together with improved nutrition and with the development of health-promoting policies.