Coexistence of maternal central adiposity and child stunting in Mexico

Objective: To assess the coexistence of maternal adiposity and child stunting (CS) in Mexico, estimate its national prevalence and identify the associated socio-demographic factors. Methods: A secondary analysis from the Mexican Nutrition Survey 1999, a nationally representative survey, was conducted. Mother and children subsamples were matched and a total of 6225 mother/child pairs were obtained. Stunting was defined as height-for-age z-scores <-2.0. Maternal body mass index (BMI) was classified according to World Health Organization recommended cutoff points. Waist-to-hip ratio (WHR) was calculated by dividing waist by hip circumferences. Logistic regression models were fitted to explore the coexistence of CS and maternal central adiposity (MCA) (WHR >= 0.85) while controlling for biological and socio-demographic factors. Results: A total of 5974 pairs had complete information. MCA coexisted with CS in 6.2% of the mother/child pairs. The phenomenon was more prevalent in rural locations, in the south region and among indigenous families (14.5, 12.5 and 23.9%). After controlling for child age and maternal BMI, a 78% increase in the likelihood of CS was related to maternal WHR >= 0.85 (odds ratio (OR) 1.78, 95% confidence interval (CI) 1.53, 2.10). After controlling for maternal height, the magnitude of the OR decreased (OR 1.33, 95% CI 1.13, 1.57), but remained significant. Therefore, it is suggested that women with a WHR similar to 1 have had twice the probability of having a stunted child as those with a WHR of 0.65. Conclusion: Although MCA and CS are two conditions frequently regarded as result of opposite determinants, our observation suggests that this is not necessarily the case, particularly in populations undergoing the nutrition transition. MCA was associated not only to chronic diseases, but also to child stunting.