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Preconception and Prenatal Environment and Growth Faltering Among Children in Uganda
Paddy Ssentongo1,2, Claudio Fronterre3, Jessica E Ericson4
1Division of Infectious Diseases and Epidemiology, Department of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania.
JAMA Network Open
|March 19, 2025
Summary
Prenatal and preconception weather patterns, including rainfall and drought indices, significantly impact child growth in Uganda. Understanding these environmental factors can improve public health strategies for child nutrition.
Area of Science:
- Environmental epidemiology
- Child health
- Public health
Background:
- Childhood growth faltering increases susceptibility to infections and can lead to developmental impairments.
- Understanding environmental influences on child growth is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between prenatal and preconception meteorological and environmental factors and childhood growth outcomes in Uganda.
- To analyze village-level growth faltering rates in relation to environmental exposures.
Main Methods:
- Cross-sectional study using data from the 2016 Ugandan Demographic and Health Survey (n=5219, aged 0-59 months).
- Assessed meteorological factors (SPEI, Aridity Index, rainfall, temperature), environmental data (nighttime lights, driving time), and topography.
- Analyzed height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) z scores, with spatial resolution estimates.
Main Results:
- 30.22% stunting, 12.23% underweight, and 3.63% wasting observed in children.
- Significant spatial disparities in growth faltering prevalence across Uganda.
- Higher Standardized Precipitation-Evapotranspiration Index (SPEI) and rainfall before birth were positively associated with improved HAZ, WAZ, and WHZ.
Conclusions:
- Prenatal and preconception rainfall and water availability positively correlate with child nutritional status in Uganda.
- Environmental factors significantly influence the spatial distribution of undernutrition.
- Findings can inform precision public health programs for cost-effective delivery.
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