Abstract
BackgroundSocioeconomic disadvantage is associated with shorter adult stature. Few studies have examined socioeconomic differences in stature from birth to childhood and the mechanisms involved, particularly in middle-income former Soviet settings.MethodsThe sample included 12,463 Belarusian children (73% of the original cohort) born in 1996–1997, with up to 14 stature measurements from birth to 7 years. Linear spline multi-level models with 3 knots at 3, 12 and 34 months were used to analyse birth length and growth velocity during four age-periods by parental educational achievement (up to secondary school, advanced secondary/partial university, completed university) and occupation (manual, non-manual).ResultsGirls born to the most (versus least) educated mothers were 0.43 cm (95% confidence interval (CI): 0.28, 0.58) longer at birth; for boys, the corresponding difference was 0.30 cm (95% CI: 0.15, 0.46). Similarly, children of the most educated mothers grew faster from birth-3 months and 12–34 months (p-values for trend ≤0.08), such that, by age 7 years, girls with the most (versus least) educated mothers were 1.92 cm (95% CI: 1.47, 2.36) taller; after controlling for urban/rural and East/West area of residence, this difference remained at 1.86 cm (95% CI: 1.42, 2.31), but after additionally controlling for mid-parental height, attenuated to 1.10 cm (95% CI: 0.69, 1.52). Among boys, these differences were 1.95 cm (95% CI: 1.53, 2.37), 1.89 cm (95% CI: 1.47, 2.31) and 1.16 cm (95% CI: 0.77, 1.55), respectively. Additionally controlling for breastfeeding, maternal smoking and older siblings did not substantively alter these findings. There was no evidence that the association of maternal educational attainment with growth differed in girls compared to boys (p for interaction = 0.45). Results were similar for those born to the most (versus least) educated fathers, or who had a parent with a non-manual (versus manual) occupation.ConclusionsIn Belarus, a middle-income former Soviet country, socioeconomic differences in offspring growth commence in the pre-natal period and generate up to approximately 2 cm difference in height at age 7 years. These associations are partly explained by genetic or other factors influencing parental stature.Trial RegistrationCurrent Controlled Trials: NCT01352247 assigned 9 Sept 2005; ClinicalTrials.gov. Identifier: NCT01561612 received 20 Mar 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-932) contains supplementary material, which is available to authorized users.
Highlights
Socioeconomic disadvantage is associated with shorter adult stature
We examine when socioeconomic differences in length/height emerge, whether they change with age, and the effect of controlling for prolonged and exclusive breastfeeding, maternal smoking, the number of older siblings and mid-parental height to shed light on potential mechanisms generating socioeconomic differences in birth size and postnatal stature
Study design and participants The study cohort is based on 17,046 children and their mothers who were originally recruited during their postpartum hospital stay into the Promotion of Breastfeeding Intervention Trial (PROBIT) [32] in Belarus in 1996–1997
Summary
Socioeconomic disadvantage is associated with shorter adult stature. Few studies have examined socioeconomic differences in stature from birth to childhood and the mechanisms involved, in middle-income former Soviet settings. Better living conditions in high-income countries may lead to improvements in childhood health, environment and social conditions [15] and may reduce adverse environmental effects, allowing genetic potential to be reached and a reduction in socioeconomic differences. Factors such as improved infant-feeding [19], reductions in maternal smoking [20,21] and overcrowding [19] or other environmental features may affect children’s stature. Parental height reflects both environmental and genetic influences [22] on growth but is not immediately modifiable
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