Association of maternal stature with offspring mortality, underweight, and stunting in low- to middle-income countries

Emre Özaltin, Kenneth Hill, S. V. Subramanian

Research output: Contribution to journalArticlepeer-review


Context: Although maternal stature has been associated with offspring mortality and health, the extent to which this association is universal across developing countries is unclear. Objective: To examine the association between maternal stature and offspring mortality, underweight, stunting, and wasting in infancy and early childhood in 54 low- to middle-income countries. Design, Setting, and Participants: Analysis of 109 Demographic and Health Surveys in 54 countries conducted between 1991 and 2008. Study population consisted of a nationally representative cross-sectional sample of children aged 0 to 59 months born to mothers aged 15 to 49 years. Sample sizes were 2 661 519 (mortality), 587 096 (underweight), 558 347 (stunting), and 568 609 (wasting) children. Main Outcome Measures: Likelihood of mortality, underweight, stunting, or wasting in children younger than 5 years. Results: The mean response rate across surveys in the mortality data set was 92.8%. In adjusted models, a 1-cm increase in maternal height was associated with a decreased risk of child mortality (absolute risk difference [ARD], 0.0014; relative risk [RR], 0.988; 95% confidence interval [CI], 0.987-0.988), underweight (ARD, 0.0068; RR, 0.968; 95% CI, 0.968-0.969), stunting (ARD, 0.0126; RR, 0.968; 95% CI, 0.967-0.968), and wasting (ARD, 0.0005; RR, 0.994; 95% CI, 0.993-0.995). Absolute risk of dying among children born to the tallest mothers (≥160 cm) was 0.073 (95% CI, 0.072-0.074) and to those born to the shortest mothers (<145 cm) was 0.128 (95% CI, 0.126-0.130). Country-specific decrease in the risk for child mortality associated with a 1-cm increase in maternal height varied between 0.978 and 1.011, with the decreased risk being statistically significant in 46 of 54 countries (85%) (α=.05). Conclusion: Among 54 low- to middle-income countries, maternal stature was inversely associated with offspring mortality, underweight, and stunting in infancy and childhood.

Original languageEnglish (US)
Pages (from-to)1507-1516
Number of pages10
JournalJAMA - Journal of the American Medical Association
Issue number15
StatePublished - Apr 21 2010
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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