MATERNAL AND SOCIOECONOMIC-FACTORS AND THE RISK OF SEVERE MALNUTRITION IN A CHILD - A CASE-CONTROL STUDY

Objective: To examine the relation of maternal and socioeconomic facto rs with the development of severe malnutrition in young children, Desi gn: A case-control study. Setting: A large diarrhoea treatment centre in a metropolitan city. Subjects: Cases were 125 severely malnourished children, aged <36 months, having weight-for-age <55% of the United S tates National Center for Health Statistics (NCHS) median values. Cont rols (n = 125) were recruited concurrently matching for gender, diseas e type (i.e. diarrhoea or dysentery) and age stratum, having weight-fo r-age >60% of NCHS median values. Intervention: Mothers of the childre n were interviewed to record personal history and various socioeconomi c variables and examined for height and weight. Results: Maternal fact ors such as illiteracy, mothers' employment outside, lack of breastfee ding and maternal malnutrition (as indicated by low body mass index, w eight or height); and selected socioeconomic indicators such as poor f amily income, use of unprotected surface water or unhygienic latrine w ere found to be significantly associated with severe malnutrition in t heir children. In multivariate analysis, maternal illiteracy and lack of breastfeeding were associated with approximately fourfold increased risk of severe malnutrition in their children. A strong positive asso ciation of employment of mothers outside homes with fivefold increased risk was surprising and may reflect a complex social problem of poor urban mothers; malnourished mothers were 2.5 times more likely to have severely malnourished children. Conclusion: The findings confirm the well-known association of lack of maternal education and breastfeeding with severe malnutrition of their children. Maternal malnutrition may be a useful indicator to identify at-risk families with severely maln ourished children. However, its causal association, though plausible, cannot be inferred from the study.