Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey

Background There has been limited research on the relationship between contraception and child growth in low-income and middle-income countries (LMICs). This study examines the association between contraception and child linear growth in Guatemala, an LMIC with a very high prevalence of child stunti...

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Main Authors: Boris Martinez, Peter Rohloff, David Flood, Ashley Petersen, Anita Chary, Kirsten Austad
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/3/1/e000510.full
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author Boris Martinez
Peter Rohloff
David Flood
Ashley Petersen
Anita Chary
Kirsten Austad
author_facet Boris Martinez
Peter Rohloff
David Flood
Ashley Petersen
Anita Chary
Kirsten Austad
author_sort Boris Martinez
collection DOAJ
description Background There has been limited research on the relationship between contraception and child growth in low-income and middle-income countries (LMICs). This study examines the association between contraception and child linear growth in Guatemala, an LMIC with a very high prevalence of child stunting. We hypothesise that contraceptive use is associated with better child linear growth and less stunting in Guatemala.Methods Using representative national data on 12 440 children 0–59 months of age from the 2014–2015 Demographic and Health Survey in Guatemala, we constructed multivariable linear and Poisson regression models to assess whether child linear growth and stunting were associated with contraception variables. All models were adjusted for a comprehensive set of prespecified confounding variables.Results Contraceptive use was generally associated with modest, statistically significant greater height-for-age z-score. Current use of a modern method for at least 15 months was associated with a prevalence ratio of stunting of 0.87 (95% CI 0.81 to 0.94; p<0.001), and prior use of a modern method was associated with a prevalence ratio of stunting of 0.93 (95% CI 0.87 to 0.98; p<0.05). The severe stunting models found generally similar associations with modern contraceptive use as the stunting models. There was no significant association between use of a modern method for less than 15 months and the prevalence ratio of stunting or severe stunting.Conclusions Contraceptive use was associated with better child linear growth and less child stunting in Guatemala. In addition to the human rights imperative to expand contraceptive access and choice, family planning merits further study as a strategy to improve child growth in Guatemala and other countries with high prevalence of stunting.
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spelling doaj-art-5b857fce9c1149229ce7e5e1b20bbb302025-08-20T02:51:46ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722019-09-013110.1136/bmjpo-2019-000510Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health SurveyBoris Martinez0Peter Rohloff1David Flood2Ashley Petersen3Anita Chary4Kirsten Austad51 Wuqu` Kawoq, Santiago Sacatepéquez, Guatemala9 Center for Indigenous Health Research, Wuqu’ Kawoq | Maya Health Alliance, Tecpán, Chimaltenango, GuatemalaDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA7 University of Minnesota School of Public Health, Minneapolis, Minnesota, USACenter for Indigenous Health Research, Wuqu Kawoq | Maya Health Alliance, Tecpán, Chimaltenango, Guatemala1 Wuqu` Kawoq, Santiago Sacatepéquez, GuatemalaBackground There has been limited research on the relationship between contraception and child growth in low-income and middle-income countries (LMICs). This study examines the association between contraception and child linear growth in Guatemala, an LMIC with a very high prevalence of child stunting. We hypothesise that contraceptive use is associated with better child linear growth and less stunting in Guatemala.Methods Using representative national data on 12 440 children 0–59 months of age from the 2014–2015 Demographic and Health Survey in Guatemala, we constructed multivariable linear and Poisson regression models to assess whether child linear growth and stunting were associated with contraception variables. All models were adjusted for a comprehensive set of prespecified confounding variables.Results Contraceptive use was generally associated with modest, statistically significant greater height-for-age z-score. Current use of a modern method for at least 15 months was associated with a prevalence ratio of stunting of 0.87 (95% CI 0.81 to 0.94; p<0.001), and prior use of a modern method was associated with a prevalence ratio of stunting of 0.93 (95% CI 0.87 to 0.98; p<0.05). The severe stunting models found generally similar associations with modern contraceptive use as the stunting models. There was no significant association between use of a modern method for less than 15 months and the prevalence ratio of stunting or severe stunting.Conclusions Contraceptive use was associated with better child linear growth and less child stunting in Guatemala. In addition to the human rights imperative to expand contraceptive access and choice, family planning merits further study as a strategy to improve child growth in Guatemala and other countries with high prevalence of stunting.https://bmjpaedsopen.bmj.com/content/3/1/e000510.full
spellingShingle Boris Martinez
Peter Rohloff
David Flood
Ashley Petersen
Anita Chary
Kirsten Austad
Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey
BMJ Paediatrics Open
title Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey
title_full Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey
title_fullStr Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey
title_full_unstemmed Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey
title_short Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey
title_sort associations between contraception and stunting in guatemala secondary analysis of the 2014 2015 demographic and health survey
url https://bmjpaedsopen.bmj.com/content/3/1/e000510.full
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