Relationship Between Wasting and Stunting in Infants from Banke, Nepal (P10-002-19)

Abstract

Objectives Stunting and wasting in early life increase the risk of mortality. While assessed and diagnosed as individual conditions, these two forms of malnutrition often coexist within the same populations and possibly the same individual. The main objective of our analysis was to assess the magnitude of stunting and wasting among Nepali infants in the first 12 months of life and to investigate the association of early life wasting on later stunting. Methods For this analysis, we utilized anthropometric data collected in a longitudinal birth cohort study with 1675 maternal-infant dyads. Birth length and weight were collected within 72 hours of birth in 95% of the infants and 88% were followed through 12 months of age. Length, weight measurements were collected on the infants at 3, 6, 9 and 12 months of age. Measurements were converted to z-scores for weight-for-length (WLZ) and length-for-age (LAZ) using World Health Organization Standards. Outliers were defined as WLZ < -5 or >5 and LAZ < -6 or >6. Wasting was defined as WLZ < -2 and stunting as LAZ < -2. Statistical analyses were conducted in Stata® SE version 14. Results In the study population, 7%, 8%, 14% and 17% were wasted while 13%, 15%, 20% and 28% of infants were stunted at 3, 6, 9 and 12 months, respectively. Bivariate analyses showed significantly positive associations between wasting and stunting at 6, 9 and 12 months of age. After controlling for gender, birth weight, maternal height, maternal education, and household food insecurity, being wasted at any one visit during the first 9 months of life was associated with almost double the odds of being stunted at 9 months (AOR: 1.74 (CI: 1.23–2.48), P = 0.002), as was being wasted at any one visit during the first 12 months of life and stunting at 12 months (AOR: 2.21 (CI: 1.68–2.92), P = 0.000). The number of times wasted in the past year was not associated with higher odds of stunting. Conclusions Both wasting and stunting prevalence increased in Nepali infants in the first 12 months of life. Wasting was a significant predictor of stunting at 9 and 12 months of age. A single episode of wasting was sufficient to increase risk of stunting as observed by the lack of effect of cumulative wasting. Targeting and addressing the wasting observed is critical for long-term well being and development of Nepali infants. Funding Sources AID-OAA-L-1-00005, AID-OAA-L-1-00006, and AID-OAA-G-14-00002.