SynthesisBMJ global health2021
Growth patterns by sex and age among under-5 children from 87 low-income and middle-income countries.
Synthesis in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Anthropometric deficits and the associated risk of death by age and sex in children aged 6-59 months: A meta-analysis.Maternal & child nutrition · 2023Pooled it
- Trial
- Prenatal and postnatal household air pollution and longitudinal growth trajectories: results from long-term follow up of the GRAPHS cohort.Environment international · 2026Article
- Reduced rank regression-derived dietary patterns related to climate-sensitive micronutrients and their associations with child undernutrition among young children in rural Kenya: findings from the ALIMUS study.BMC public health · 2026Article
- A prediction nomogram for faltering catch-up growth in full-term small-for-gestational-age infants: a retrospective cohort study.Frontiers in pediatrics · 2026Article
- The potential pathway from maternal intimate partner violence to early childhood development through height-for-age z-score: evidence from 10 low- and middle-income countries.Frontiers in public health · 2026Article
- Determinants of growth parameters at 12-month corrected age among very preterm infants in China: a retrospective cohort study.Frontiers in pediatrics · 2026Article
- Food security and its impact on growth among Sri Lankan children under five during the economic crisis in 2022.BMC nutrition · 2025Article
- Provision of a liquefied petroleum gas cookstove and fuel during pregnancy and infancy and linear growth trajectories between birth and 12 months: Evidence from the multi-center Household Air Pollution Intervention Network (HAPIN) trial.PLOS global public health · 2025Article
- A four-year, mixed-family and community-based growth monitoring and promotion program using multi-level modeling to address undernutrition in children in Cambodia.Frontiers in public health · 2025Article
- Estimating program coverage in the treatment of acute malnutrition using population-based cluster survey methods: results from surveys in Burkina Faso, Chad, Democratic Republic of the Congo, and Niger.Frontiers in public health · 2025Article
- Are boys more vulnerable to stunting? Examining risk factors, differential sensitivity, and measurement issues in Zambian infants and young children.BMC public health · 2024Article
- How age and sex affect treatment outcomes for children with severe malnutrition: A multi-country secondary data analysis.Maternal & child nutrition · 2024Article
- Longitudinal trajectories of the overall and regional body composition between severe acute malnourished and well-nourished children of Rohingya refugee camps.Frontiers in public health · 2024Article
- Growth Velocity and Nutritional Status in Children Exposed to Zika Virus during Pregnancy from Amazonas Cohort, Brazil.Viruses · 2023Article
- Article
- Review
- Prevalence of undernutrition and associated factors in young children in Malaysia: A nationwide survey.Frontiers in pediatrics · 2022Article
- Detecting Age Prone to Growth Retardation in Children Through a Bi-Response Nonparametric Regression Model with a Penalized Spline Estimator.Iranian journal of nursing and midwifery researchArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
introductionAlthough boys tend to be more affected by linear growth faltering than girls, little is known about sex differences across distinct age groups. We aimed to compare sex differences in linear growth throughout the first 5 years of life among children from low-income and middle-income countries.
methodsWe analysed 87 cross-sectional Demographic and Health Surveys and Multiple Cluster Indicator Surveys (2010-2019). Growth was expressed as height-for-age z-scores (HAZ) based on the 2006 WHO Growth Standards. Sex-specific means were estimated for each country and results were pooled through random-effects meta-analysis for all children and by 12-month age groups. Using linear regression, we assessed the association between sex differences in HAZ and gross domestic product as a proxy for national economic development.
resultsBoys presented lower mean HAZ than girls in the first 30 months. Sex differences were mostly absent between 30 and 45 months, and in several countries, girls had lower HAZ at ages over 45 months. The pooled sex difference (boys minus girls) for the whole sample was -0.10 (95% CI -0.12 to -0.08). The difference was -0.17 (95% CI -0.20 to -0.14) at 0-11 months and -0.22 (95% CI -0.25 to -0.19) at 12-23 months. This was followed by a narrowing of the sex gap to -0.10 (95% CI -0.13 to -0.07) and -0.04 (95% CI -0.07 to -0.01) among children aged 24-35 and 36-47 months, respectively. At 48-59 months, there was evidence of female disadvantage; the mean height-for-age of boys was 0.02 (95% CI 0.00 to 0.05) SDs higher than for girls. Ecological analyses showed that in all age groups, male disadvantage decreased with increasing national income, and this was no longer present for the 4-year-old children, particularly in wealthier countries.
conclusionMale disadvantage in linear growth is most evident in the first years, but by the age of 4 years, the sex gap has mostly disappeared, and in some countries, the gap has been reversed.
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