Preschool stunting, adolescent migration, catch-up growth, and adult height in young senegalese men and women of rural origin

Abstract

Available data on the long-term consequences of preschool stunting are scarce and conflicting. The objective of this study was to assess the amount of catch-up growth from preschool stunting and the effect of migration (change in environment) during adolescence. A cohort study from preschool age (1-5 y) to adulthood (18-23 y) was conducted among 2874 subjects born in a rural area of Senegal. The subjects were divided into 3 groups of preschool stunting: none, mild, and marked, with height-for-age Z-scores of >-1, -2 to -1, and <-2, respectively. At follow-up, the history of migration was recalled. Mean height was 161.3 cm for girls and 174.0 cm for boys (>/=20 y). Stunted subjects remained smaller than the others: the age-adjusted height deficit between the 2 extreme categories was 6.6 and 9.0 cm in girls and boys, respectively. However, their height increment from early childhood to adulthood differed (69.3, 70.5, and 72.0 cm, P = 0.0001, and 78.9, 80.0, and 80.3 cm, P < 0.01, for nonstunted, mildly stunted, and markedly stunted girls and boys, respectively). The duration of labor migration to the city was associated with height increment in girls only in a nonlinear relation (adjusted means: 67.2, 69.3, 67.4, and 67.7 cm for 4 groups of increasing duration, P < 0.01). In conclusion, Senegalese children caught up in height prior to adulthood, with the adult means approximately 2 cm below the WHO/NCHS reference. However, this global catch up did not reduce height differences between formerly stunted and nonstunted children to any greater extent and it was not enhanced by labor migration.