|dc.description.abstract||Chronic malnutrition, often measured as stunted growth, is an understudied global health problem.
Though poor nutritional intake has been linked to stunted growth, there is evidence suggesting environmental
exposures may have a significant role in its occurrence. Here, we characterize the non-nutritional prenatal and
postnatal factors that contribute to early childhood stunted growth in rural coastal Kenya Overall, 232 women and 244 children from a 2012–2015 maternal-child cohort in Msambweni, Kenya
were included. Women were tested for parasitic infections during the prenatal period and at the time of delivery.
Children were tested for parasitic infections and assessed for stunted growth using height-for-age Z-scores (HAZ) at
6-month intervals after birth. Socioeconomic status (SES) was evaluated using both a simplified water, asset,
maternal education, and income (WAMI) index and a principal component analysis (PCA) asset score. Multivariate
logistic regression analysis was used to determine the relative influence of prenatal and postnatal factors on the
occurrence of stunted growth.
Of the 244 children (ages 6–37 months), 60 (25%) were stunted at the study endpoint. 179 mothers (77%)
had at least one parasitic infection during pregnancy and 94 children (38%) had at least one parasitic infection
during the study period. There was no significant association between maternal parasitic infection and child
stunted growth (p = 1.00). SES as determined using the WAMI index was not associated with HAZ in linear
regression analysis (p = 0.307), however, the PCA asset score was (p = 0.048). Multivariate logistic regression analysis
identified low birth weight (AOR: 3.24, 95% CI: [1.38, 7.57]) and child parasitic infectious disease burden (AOR: 1.41,
95% CI: [1.05, 1.95]) as independent predictors of stunted growth, though no significant association was identified
with PCA asset score (AOR: 0.98, 95% CI: [0.88, 1.10]).
Stunted growth remains highly prevalent in rural Kenya, with low birth weight and child parasitic
infectious disease burden demonstrated to be significantly associated with this indicator of chronic malnutrition.
These results emphasize the multifaceted nature of stunted growth and the need to address both the prenatal and
postnatal environmental factors that contribute to this problem||en_US