Early Childhood Stunting Is Associated with Lower Developmental Levels in the Subsequent Generation of Children

Background: Linear growth retardation (stunting) is associated with lower adult cognition, educational attainment, and income. These effects, together with possible effects of stunting on birth weight and subsequent growth of offspring, suggest that stunting could be associated with poor development in the next generation of children. Objective: The objective was to compare developmental levels in children born to parents who were stunted or nonstunted in early childhood. Methods: This is a prospective cohort study of the children of participants in the Jamaica supplementation and stimulation study. The analysis compared children born to a parent who was stunted at age 9-24 mo, and did not receive the stimulation intervention, with children born to a parent in the nonstunted group. Developmental levels were measured with the Griffiths mental, development scales between ages 12 and 72 mo. Mixed model regression analyses were conducted to allow for clus.tering of children within families and child (repeat assessments). The analyses included 89 children with a total of 156 assessments. Caregiver and home characteristics associated with the developmental quotient (DO) or any of the subscales were included in the regressions. Results: Children born to a stunted parent had lower DQs (-5.29 points; 95% Cl: 9.06, 1.52 points; P = 0.01) and lower scores on the cognitive subscale (-5.77 points; 95% CI: 10.68, 0.87 points; P= 0.022). The offspring of stunted parents had lower height-for-age (-0.61 z scores; 95% Cl: 1.13, 0.10 z scores; P= 0.021). In analyses, adjusting for child height-for-age or birth weight, the developmental differences remained significant. Conclusions: To our knowledge, this is the first report comparing the development of offspring of persons stunted in early childhood to the development of offspring of nonstunted parents. The findings suggest that the impact of stunting on development continues in the next generation of children. If replicated, these findings have important implications for estimation of the cost of stunting to social and economic development.