A mother's shorter height is associated with a reduced growth rate and a higher death rate for her children, among 54 low- to middle-income countries, according to a study in the April 21 issue of JAMA.

Researchers say the association suggests the presence of "an intergenerational transmission from mother's own nutrition, disease, and socioeconomic circumstances during her childhood to her offspring's health and mortality in their infancy and childhood."

Scientists investigated the potential long-term effects of maternal stature on offspring mortality, underweight, stunting, and wasting in infancy and early childhood. The study included an analysis of 109 Demographic and Health Surveys in 54 low- to middle-income countries, conducted between 1991 and 2008.

The study population consisted of a nationally representative cross-sectional sample of children ages 0 to 59 months born to mothers ages 15 to 49 years. Sample sizes were 2,661,519 (mortality), 587,096 (underweight), 558,347 (stunting), and 568,609 (wasting) children. The average response rate across surveys in the mortality data set was 92.8 percent.

Of the more than 2.6 million children in the study, 11.7 percent died before reaching 5 years of age. The prevalence of child mortality ranged from 24.7 percent in Niger to 3.3 percent in Jordan.

In adjusted models, a 0.4 inch increase in maternal height was associated with a decreased risk of offspring mortality, underweight, stunting, and wasting. Compared with the tallest mothers (5'3" or taller), each lower height category had substantially higher risk of child mortality, with children born to mothers of height shorter than 4'9" having an increased risk of death of nearly 40 percent. Mortality risk associated with increased height was decreased in 52 of 54 countries and was statistically significant in 46 of 54 countries.

"Underscoring the policy significance of this association, for child mortality, the effect of being in the lowest height category (relative to the tallest) was approximately 70 percent and 80 percent of the size of the effect of having no education or being in the poorest income quintile, respectively," the authors write.

"For childhood underweight and stunting, maternal height was the most important factor, with an effect size about twice that of being in the lowest education category and 1.5 times that of being in the poorest quintile."

Citation: Emre Özaltin, Kenneth Hill, S. V. Subramanian, Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- to Middle-Income Countries', JAMA, April 2010, 303(15), 1507-1516