Abstract
This analysis was conducted to explore the association between 5 birth size measurements (weight, length and head, chest and mid-upper arm [MUAC] circumferences) as dependent variables and 10 maternal factors as independent variables using canonical correlation analysis (CCA). CCA considers simultaneously sets of dependent and independent variables and, thus, generates a substantially reduced type 1 error. Data were from women delivering a singleton live birth (n = 14506) while participating in a double-masked, cluster-randomized, placebo-controlled maternal vitamin A or β-carotene supplementation trial in rural Bangladesh. The first canonical correlation was 0.42 (P<0.001), demonstrating a moderate positive correlation mainly between the 5 birth size measurements and 5 maternal factors (preterm delivery, early pregnancy MUAC, infant sex, age and parity). A significant interaction between infant sex and preterm delivery on birth size was also revealed from the score plot. Thirteen percent of birth size variability was explained by the composite score of the maternal factors (Redundancy, RY/X = 0.131). Given an ability to accommodate numerous relationships and reduce complexities of multiple comparisons, CCA identified the 5 maternal variables able to predict birth size in this rural Bangladesh setting. CCA may offer an efficient, practical and inclusive approach to assessing the association between two sets of variables, addressing the innate complexity of interactions.
Highlights
There is a growing interest among maternal and child health researchers in studying the relationship between birth size and maternal socio-demographic and health factors
The aim of this research is to explore the relationship between birth size and maternal factors using canonical correlation analysis (CCA) in a community based maternal and child health and nutrition research project
Study design and participants The data reported in this analysis were collected during a field based double-masked, cluster randomized, placebo-controlled trial assessing the efficacy of maternal vitamin A or b-carotene supplementation on maternal and infant mortality through 6 months of age from January 2002 to July 2007
Summary
There is a growing interest among maternal and child health researchers in studying the relationship between birth size and maternal socio-demographic and health factors. It is universally recognized that birth size is a lagged indicator of fetal health and predictive of neonatal health and survival. Fetal growth is largely, but not solely, determined by the availability of nutrients from the mother before and during gestation, as well as placental capacity to supply these nutrients in sufficient quantities to the fetus [3], and birth size can reflect the intrauterine environment. Maternal nutritional status largely depends on socio-economic factors. Small birth size is more common in resource poor settings or among more disadvantaged populations [4,5,6]
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