Exposure to Ambient Fine Particulate Air Pollution in Utero as a Risk Factor for Child Stunting in Bangladesh

Goyal, Nihit; Canning, David

doi:10.3390/ijerph15010022

Cited by 33 publications

(35 citation statements)

References 42 publications

(52 reference statements)

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“…Reductions in diarrhea frequency predicted only 1% of HAZ change in Cambodia ( 55 ). Diarrhea was significantly associated with odds of stunting in Cambodia ( 55 ), Bangladesh ( 41 ), Malawi ( 37 , 75 ), and Uganda ( 101 ), although the effect size varied. The relation between the incidence of diarrhea and growth outcomes in children was examined in 11 studies in total ( 14 , 21 , 35 , 37 , 41 , 55 , 62 , 66 , 75 , 97 , 98 ).…”

Section: Resultsmentioning

confidence: 99%

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Vaivada

Akseer

et al. 2020

The American Journal of Clinical Nutrition

196

106

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Background Progress has been made worldwide in reducing chronic undernutrition and rates of linear growth stunting in children under 5 y of age, although rates still remain high in many regions. Policies, programs, and interventions supporting maternal and child health and nutrition have the potential to improve child growth and development. Objective This article synthesizes the available global evidence on the drivers of national declines in stunting prevalence and compares the relative effect of major drivers of stunting decline between countries. Methods We conducted a systematic review of published peer-reviewed and gray literature analyzing the relation between changes in key determinants of child linear growth and contemporaneous changes in linear growth outcomes over time. Results Among the basic determinants of stunting assessed within regression-decomposition analyses, improvement in asset index score was a consistent and strong driver of improved linear growth outcomes. Increased parental education was also a strong predictor of improved child growth. Of the underlying determinants of stunting, reduced rates of open defecation, improved sanitation infrastructure, and improved access to key maternal health services, including optimal antenatal care and delivery in a health facility or with a skilled birth attendant, all accounted for substantially improved child growth, although the magnitude of variation explained by each differed substantially between countries. At the immediate level, changes in several maternal characteristics predicted modest stunting reductions, including parity, interpregnancy interval, and maternal height. Conclusions Unique sets of stunting determinants predicted stunting reduction within countries that have reduced stunting. Several common drivers emerge at the basic, underlying, and immediate levels, including improvements in maternal and paternal education, household socioeconomic status, sanitation conditions, maternal health services access, and family planning. Further data collection and in-depth mixed-methods research are required to strengthen recommendations for those countries where the stunting burden remains unacceptably high.

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Section: Resultsmentioning

confidence: 99%

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Vaivada

Akseer

et al. 2020

The American Journal of Clinical Nutrition

196

106

View full text Add to dashboard Cite

show abstract

“…The mothers with short height (<145 cm) had 4.7 times (95% CI: 2.28-9.56) higher chance of having a stunted child compared to mothers with higher height (Hasan et al, 2019). Goyal and Canning (2017) reported the children whose mothers age less than 18 years old were 1.15 times (95% CI:…”

Section: Maternal Factorsmentioning

confidence: 98%

Determinants of stunting during the first 1,000 days of life in Bangladesh: A review

Islam

Ullah

Mainali³

et al. 2020

Food Science & Nutrition

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Stunting is a major problem in Bangladesh, with a prevalence of 31% in 2017. The prevalence of stunting in children aged under two has reduced by only 6% since 2004. After children reach 2 years of age, the consequences of stunting become almost irreversible. This paper seeks to examine and analyze the determinants associated with stunting during the first 1,000 days of life in Bangladesh to assist in developing evidence‐based interventions in Bangladesh. A literature review was conducted comprehensively on all relevant peer‐reviewed and gray literature of studies conducted in Bangladesh. The existing literature was searched and examined using the World Health Organization (WHO) conceptual framework for stunting. Evidence indicates that low maternal weight, lack of maternal education, severe food insecurity, lack of access to suitable nutrition, nonexclusive breastfeeding, pathogen‐specific diarrhea, and low weight and height at birth are associated with early childhood stunting in Bangladesh. The relation of the quality of drinking water with stunting is not clear in Bangladesh. Literature about the association between stunting and determinants such as the political economy, education systems, and agriculture and food systems is not found. This synthesis shows that the factors of stunting are multifaceted. As such, a multi‐sectoral approach is essential in Bangladesh, employing evidence‐based interventions to address the determinants that contribute to the risk of stunting to achieve the global nutrition target by 2025.

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“…These estimates, however, rely on concentration-response functions that were developed from epidemiological studies carried out primarily in high-income countries. Moreover, the empidemiological studies used for constructing these estimates do not consider impacts on a number of child health outcomes that have been linked to PM 2.5 exposure, including sudden infant death syndrome [5], low birth weight [6, 7], intrauterine growth retardation [8] and reduced size [9].…”

Section: Introductionmentioning

confidence: 99%

The association of early-life exposure to ambient PM2.5 and later-childhood height-for-age in India: an observational study

et al. 2019

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Background Children in India are exposed to high levels of ambient fine particulate matter (PM 2.5 ). However, population-level evidence of associations with adverse health outcomes from within the country is limited. The aim of our study is to estimate the association of early-life exposure to ambient PM 2.5 with child health outcomes (height-for-age) in India. Methods We linked nationally-representative anthropometric data from India’s 2015–2016 Demographic and Health Survey ( n = 218,152 children under five across 640 districts of India) with satellite-based PM 2.5 exposure (concentration) data. We then applied fixed effects regression to assess the association between early-life ambient PM 2.5 and subsequent height-for-age, analyzing whether deviations in air pollution from the seasonal average for a particular place are associated with deviations in child height from the average for that season in that place, controlling for trends over time, temperature, and birth, mother, and household characteristics. We also explored the timing of exposure and potential non-linearities in the concentration-response relationship. Results Children in the sample were exposed to an average of 55 μ g/m 3 of PM 2.5 in their birth month. After controlling for potential confounders, a 100 μg/m 3 increase in PM 2.5 in the month of birth was associated with a 0.05 [0.01–0.09] standard deviation reduction in child height. For an average 5 year old girl, this represents a height deficit of 0.24 [0.05–0.43] cm. We also found that exposure to PM 2.5 in the last trimester in utero and in the first few months of life are significantly ( p < 0.05) associated with child height deficits. We did not observe a decreasing marginal risk at high levels of exposure. Conclusions India experiences some of the worst air pollution in the world. To our knowledge, this is the first study to estimate the association of early-life exposure to ambient PM 2.5 on child height-for-age at the range of ambient pollution exposures observed in India. Because average exposure to ambient PM 2.5 is high in India, where child height-for-age is a critical challenge in human development, our results highlight ambient air pollution as a public health policy priority. Electronic supplementary material The online version of this article (10.1186/s12940-019-0501-7) contains supplementary material, which is available to authorized users.

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Exposure to Ambient Fine Particulate Air Pollution in Utero as a Risk Factor for Child Stunting in Bangladesh

Cited by 33 publications

References 42 publications

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Determinants of stunting during the first 1,000 days of life in Bangladesh: A review

The association of early-life exposure to ambient PM2.5 and later-childhood height-for-age in India: an observational study

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