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Journal article
Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children
BMC pediatrics, v 24(1), 103
10 Feb 2024
PMID: 38341551
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The literature contains scarce data on inequalities in growth trajectories among children born to mothers of diverse ethnoracial background in the first 5 years of life.
We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database.
A population-based retrospective cohort study employed linked data from the CIDACS Birth Cohort and the Brazilian Food and Nutrition Surveillance System (SISVAN). Children born at term, aged 5 years or younger who presented two or more measurements of length/height (cm) and weight (kg) were followed up between 2008 and 2017. Prevalence of stunting, underweight, wasting, and thinness were estimated. Nonlinear mixed effect models were used to estimate childhood growth trajectories, among different maternal ethnoracial groups (White, Asian descent, Black, Pardo, and Indigenous), using the raw measures of weight (kg) and height (cm) and the length/height-for-age (L/HAZ) and weight-for-age z-scores (WAZ). The analyses were also adjusted for mother's age, educational level, and marital status.
A total of 4,090,271 children were included in the study. Children of Indigenous mothers exhibited higher rates of stunting (26.74%) and underweight (5.90%). Wasting and thinness were more prevalent among children of Pardo, Asian, Black, and Indigenous mothers than those of White mothers. Regarding children's weight (kg) and length/height (cm), those of Indigenous, Pardo, Black, and Asian descent mothers were on average shorter and weighted less than White ones. Regarding WAZ and L/HAZ growth trajectories, a sharp decline in average z-scores was evidenced in the first weeks of life, followed by a period of recovery. Over time, z-scores for most of the subgroups analyzed trended below zero. Children of mother in greater social vulnerability showed less favorable growth.
We observed racial disparities in nutritional status and childhood growth trajectories, with children of Indigenous mothers presenting less favorable outcomes compared to their White counterparts. The strengthening of policies aimed at protecting Indigenous children should be urgently undertaken to address systematic ethnoracial health inequalities.
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Details
- Title
- Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children
- Creators
- Helena Benes Matos da Silva - Fundação Oswaldo CruzRita de Cássia Ribeiro-Silva - Fundação Oswaldo CruzJuliana Freitas de Mello E Silva - Fundação Oswaldo CruzIrina Chis Ster - City St George's, University of LondonPoliana Rebouças - Fundação Oswaldo CruzEmanuelle Goes - Fundação Oswaldo CruzMaria Yury Ichihara - Fundação Oswaldo CruzAndrêa FerreiraJulia M Pescarini - London School of Hygiene & Tropical MedicineRosemeire Leovigildo Fiaccone - British Science AssociationEnny S Paixão - London School of Hygiene & Tropical MedicineMaurício L Barreto - Fundação Oswaldo Cruz
- Publication Details
- BMC pediatrics, v 24(1), 103
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health
- Web of Science ID
- WOS:001159314400001
- Scopus ID
- 2-s2.0-85184790160
- Other Identifier
- 991021860735004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics