Influence of socioeconomic status on the association between low weight at birth and stunted growth or overweight in rural and urban Indonesian prepubertal children

Abstract

Background Low birth weight (LBW) has been associated with in- creased risk for both stunted growth andand overweight later in life. Objective To assess relative contribution of LBW on the preva- lence of stunted growth or overweight in rural and urban Indo- nesian children in Indonesia. Methods This is a cross-sectional survey of 2 833 (1125 rural and 1708 urban) school-aged prepubertal children. Each child had data on age, sex, stature, BMI (body mass index) and birth weight. Results Compared to the urban population, the prevalence of stunted growth was significantly higher in the rural, i.e. 16.3 vs. 32.7%, P<O.OOl. However, there was no significant difference iin n the prevalence of LBW in the two communities. While overall, stunted children were more likely to be born with LBW, OR 1.80 (95%CI 1.31; 2.47), P<O.OOl. After stratifying data into rural and urban residences, the contribution of LBW on the risk of stunted growth appeared to be only significant in the urban population, OR 2.42 (95%CI 1.59; 3.68), P<O.OOl. In the rural, similar proportions of LBW were found in stunted and not stunted children. Test of in- teraction showed that this difference in OR was significant, the ratio of OR 1.88 (95%CI 1.11; 3.17), P=0.02. We observed no association between LBW and overweight. Conclusions In rural area, LBW is not an important contributor for stunted growth, while in urbanarea LBW is an important risk factor for stunted growth. As there is no significant difference in the prevalence of LBW between the two communities, the dif- ference in the prevalence of stunted growth is more likely to be associated with different pattern of post-natal growth