Stunted growth in a cohort of two-year olds in the Khanh Hoa province in Vietnam - a follow-up study.

Objectives: Vietnam is undergoing rapid socio-economic changes. The Vietnamese government has introduced programmes to combat malnutrition and stunted child-growth twice during the past decade. However, in a recent study of a cohort in the Khanh Hoa province the proportion of children in late infancy with short stature was three fold that expected under the new WHO growth standards. The findings warranted a follow-up study of this cohort. In the present study, stature growth of the cohort was assessed at age two years using the same growth standards as reference, and potential risk factors for short stature were analysed. Methods: A cohort of 237 singleton infants born at term in the period May to July 2005 in three main delivery clinics in the Khanh Hoa province were followed prospectively. Their height-for-age two years later was analysed using the new WHO sex-specific growth standards and compared with short stature at age one. Associations between short-stature-for-age and parity, rurally born, maternal age, duration of breastfeeding, and disease in the second year of life were investigated. Results: Twenty-six percent (95% confidence interval: 20.4-32.4%) of the children were within the 5th percentile of the standards for height-for-age. Of these, 38% had been within the same percentile at age one. Neither incidence nor prevalence of short-stature-for-age were associated statistically with any of the analysed maternal and child factors. Conclusions: Based on the new WHO growth standards, the proportion of children in this cohort with stunted growth at age two was markedly higher than expected, and the majority of them did not have short stature-for-age a year earlier. These findings confirm the need for policies and early interventions to prevent stunting in Vietnam – in particular in the Khanh Hoa province. In this cohort, stunted growth at age two was not independently associated with parity, being rurally born, maternal age, duration of breastfeeding, and disease occurrences in the second year of life.