The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.

<h4>Background</h4>Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have fo...

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Autores principales:	Kun A Susiloretni, Emily R Smith, Suparmi, Marsum, Rina Agustina, Anuraj H Shankar
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a461f611f233496b9aec3be420c16b69
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spelling	oai:doaj.org-article:a461f611f233496b9aec3be420c16b692021-12-02T20:13:31ZThe psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.1932-620310.1371/journal.pone.0246725https://doaj.org/article/a461f611f233496b9aec3be420c16b692021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0246725https://doaj.org/toc/1932-6203<h4>Background</h4>Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting.<h4>Methods</h4>We used data from the Indonesia National Health Survey 2013, including 46,315 children 6-59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire (SRQ20), with height-for-age z score (HAZ), stunting, and behavioral and other risk factors for stunting.<h4>Results</h4>Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.086 (95% CI -0.17, -0.00), 0.11 (95% CI -0.24, -0.02) and 0.19 (95% CI -0.37, -0.00) HAZ-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ <-1) by 33% (95% CI 1.17,1.50) and 37% (95% CI 1.18,1.60), and the risk of moderate stunting (HAZ <-2) by 25% (95% CI 1.10,1.43) and 28% (95% CI 1.08,1.51]), respectively. Parental stress increased the risk of moderate stunting by 40% (95% CI 1.06,1.85). Amongst specific groups of risk factors, the proportion of HAZ-score lost was associated with socioeconomic factors (30.3%) including, low wealth, low maternal occupational status, low maternal education, rural residence, and low paternal occupational status; physiological factors (15.5%) including low maternal height, low maternal mid-upper arm circumference, being male, low paternal height; behavioral factors (8.9%) including open garbage disposal, paternal smoking, not using iodized salt; and experiencing at least one infectious diseases episode (1.1%).<h4>Conclusions</h4>Maternal, paternal and parental stress were associated with reduced linear growth of children. These findings highlight the complex etiology of stunting and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents must be pursued as part of a comprehensive strategy to enhance child growth and development, i.e. improved caretaker capacity, integrated community development, improved parenting skills, as well as reduced gender discrimination, and domestic violence.Kun A SusiloretniEmily R SmithSuparmiMarsumRina AgustinaAnuraj H ShankarPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0246725 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kun A Susiloretni Emily R Smith Suparmi Marsum Rina Agustina Anuraj H Shankar The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.
description	<h4>Background</h4>Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting.<h4>Methods</h4>We used data from the Indonesia National Health Survey 2013, including 46,315 children 6-59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire (SRQ20), with height-for-age z score (HAZ), stunting, and behavioral and other risk factors for stunting.<h4>Results</h4>Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.086 (95% CI -0.17, -0.00), 0.11 (95% CI -0.24, -0.02) and 0.19 (95% CI -0.37, -0.00) HAZ-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ <-1) by 33% (95% CI 1.17,1.50) and 37% (95% CI 1.18,1.60), and the risk of moderate stunting (HAZ <-2) by 25% (95% CI 1.10,1.43) and 28% (95% CI 1.08,1.51]), respectively. Parental stress increased the risk of moderate stunting by 40% (95% CI 1.06,1.85). Amongst specific groups of risk factors, the proportion of HAZ-score lost was associated with socioeconomic factors (30.3%) including, low wealth, low maternal occupational status, low maternal education, rural residence, and low paternal occupational status; physiological factors (15.5%) including low maternal height, low maternal mid-upper arm circumference, being male, low paternal height; behavioral factors (8.9%) including open garbage disposal, paternal smoking, not using iodized salt; and experiencing at least one infectious diseases episode (1.1%).<h4>Conclusions</h4>Maternal, paternal and parental stress were associated with reduced linear growth of children. These findings highlight the complex etiology of stunting and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents must be pursued as part of a comprehensive strategy to enhance child growth and development, i.e. improved caretaker capacity, integrated community development, improved parenting skills, as well as reduced gender discrimination, and domestic violence.
format	article
author	Kun A Susiloretni Emily R Smith Suparmi Marsum Rina Agustina Anuraj H Shankar
author_facet	Kun A Susiloretni Emily R Smith Suparmi Marsum Rina Agustina Anuraj H Shankar
author_sort	Kun A Susiloretni
title	The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.
title_short	The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.
title_full	The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.
title_fullStr	The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.
title_full_unstemmed	The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.
title_sort	psychological distress of parents is associated with reduced linear growth of children: evidence from a nationwide population survey.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/a461f611f233496b9aec3be420c16b69
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The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey.

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