Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children
Abstract Background 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. Objective We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Braz...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-024-04550-3 |
| _version_ | 1797273245205921792 |
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| author | Helena Benes Matos da Silva Rita de Cássia Ribeiro-Silva Juliana Freitas de Mello e Silva Irina Chis Ster Poliana Rebouças Emanuelle Goes Maria Yury Ichihara Andrêa Ferreira Julia M. Pescarini Rosemeire Leovigildo Fiaccone Enny S. Paixão Maurício L. Barreto |
| author_facet | Helena Benes Matos da Silva Rita de Cássia Ribeiro-Silva Juliana Freitas de Mello e Silva Irina Chis Ster Poliana Rebouças Emanuelle Goes Maria Yury Ichihara Andrêa Ferreira Julia M. Pescarini Rosemeire Leovigildo Fiaccone Enny S. Paixão Maurício L. Barreto |
| author_sort | Helena Benes Matos da Silva |
| collection | DOAJ |
| description | Abstract Background 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. Objective We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database. Methods 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. Results 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. Conclusion 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. |
| first_indexed | 2024-03-07T14:40:45Z |
| format | Article |
| id | doaj.art-5e491260365c4876aa889eda38e12bdb |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-03-07T14:40:45Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-5e491260365c4876aa889eda38e12bdb2024-03-05T20:22:44ZengBMCBMC Pediatrics1471-24312024-02-0124111310.1186/s12887-024-04550-3Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million childrenHelena Benes Matos da Silva0Rita de Cássia Ribeiro-Silva1Juliana Freitas de Mello e Silva2Irina Chis Ster3Poliana Rebouças4Emanuelle Goes5Maria Yury Ichihara6Andrêa Ferreira7Julia M. Pescarini8Rosemeire Leovigildo Fiaccone9Enny S. Paixão10Maurício L. Barreto11School of Nutrition, Federal University of BahiaSchool of Nutrition, Federal University of BahiaCenter for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz FoundationInfection and Immunity Research Institute, St George’s University of LondonCenter for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz FoundationEpidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Statistics, Federal University of BahiaEpidemiology and Population Health, London School of Hygiene and Tropical MedicineCenter for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz FoundationAbstract Background 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. Objective We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database. Methods 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. Results 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. Conclusion 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.https://doi.org/10.1186/s12887-024-04550-3Ethnic-racial groupsChild growth trajectoriesFood and nutrition surveillance systemRacismRace |
| spellingShingle | Helena Benes Matos da Silva Rita de Cássia Ribeiro-Silva Juliana Freitas de Mello e Silva Irina Chis Ster Poliana Rebouças Emanuelle Goes Maria Yury Ichihara Andrêa Ferreira Julia M. Pescarini Rosemeire Leovigildo Fiaccone Enny S. Paixão Maurício L. Barreto Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children BMC Pediatrics Ethnic-racial groups Child growth trajectories Food and nutrition surveillance system Racism Race |
| title | Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children |
| title_full | Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children |
| title_fullStr | Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children |
| title_full_unstemmed | Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children |
| title_short | Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children |
| title_sort | ethnoracial disparities in childhood growth trajectories in brazil a longitudinal nationwide study of four million children |
| topic | Ethnic-racial groups Child growth trajectories Food and nutrition surveillance system Racism Race |
| url | https://doi.org/10.1186/s12887-024-04550-3 |
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