Journal of Maternal and Child Health (2022), 07(04): 479-488

Meta Analysis
Masters Program in Public Health, Universitas Sebelas Maret

Maternal Age Correlates with Stunting in Children:

Systematics Review
Fardhiasih Dwi Astuti1), Arlina Azka2), Rokhmayanti Rokhmayanti1)

1)Faculty of Public Health, Ahmad Dahlan University, Yogyakarta

2)Masters Program in Public Health, Universitas Sebelas Maret

ABSTRACT

Background: Teenage mother should be ready for the consequences to come. It is important to get
prepared both mentally and economically. A teenage mother and her offspring are at risk of
malnutrition and stunting. This study aims to analyze the correlation between maternal age and the
incidence of stunting based on published articles.
Subjects and Method: A systematic review was conducted to find the correlation between
maternal age and the incidence of stunting. The research was conducted by seeking into the database
by using PubMed, Ebsco, Google Scholar, and SpringerLink. The keywords used were "risk factor"
OR “determinant” AND “stunting” AND "young maternal age" OR "adolescent mother*" OR "teen
mother*" OR "adolescent pregnancy" OR "teen pregnancy" AND "logistic regression" OR “multiva-
riate”. The obtained articles underwent screening and conformity assessment. Articles that met the
criteria were subsequently extracted.
Results: 1,048 articles were discovered from PubMed, Ebsco, Google Scholar and SpringerLink
databases and 9 of them were included in the review. The articles were from Turkey, Tanzania,
Pakistan, Ghana, Uganda, Burundi, 2 articles were from Ethiopia, and 1 article covered Brazil,
Guatemala, India, Philippines, and South Africa. The prevalence of stunting in each region from the
obtained articles showed a variation from 13.8% - 79.5%. It discovered the correlation between
maternal age during pregnancy and incidence of stunting that pregnant women under the age of 20
were at greater risk for stunting compared to women aged ≥ 20 years (OR 1.37 – 7.56). Women at a
younger age were at greater risk of having stunting children.
Conclusion: The correlation between maternal age during pregnancy and stunting indicates that
the younger the mothers, the higher the risk for stunting. The risk for stunting will decrease with the
increasing maternal age at the time of delivery.

Keywords: adolescence, stunting, teenage mothers, maternal age

Correspondence:
Fardhiasih Dwi Astuti. Jl. Prof. DR. Soepomo Sh, Warungboto, Kec. Umbulharjo, Yogyakarta City,
Special Region of Yogyakarta. Email: Fardhiasih.dwiastuti@ikm.uad.ac.id.

Cite this as:

Astuti FD, Azka A, Rokhmayanti R (2022). Maternal Age Correlates with Stunting in Children: Systematics
review. 07(04): 479-488. https://doi.org/10.26911/thejmch.2022.07.04.11.
Journal of Maternal and Child Health is licensed under a Creative Commons
Attribution-NonCommercial-ShareAlike 4.0 International License.

BACKGROUND problems are mostly in Asia and Africa.

Stunting is a condition of chronic malnutri- 54% of stunting incidences are in Asia and
tion that has an impact on growth disorders 40% in Africa. The global incidence of stun-
as indicated by a lower height than children ting in 2000 – 2019 decreased from 32.4%
of the same age. The nutritional problem to 21.3%(WHO, 2020) .
that needs to be a concern for all parties is Stunting conditions acquires short-
stunting. Regions with the malnutrition term and long-term impacts on individuals

e-ISSN: 2549-1172 479

Astuti et al./ Maternal Age Correlates with Stunting in Children

and communities that may increase mor- (Akpinar and Teneler, 2022).
bidity and mortality rate. Stunting can in- There have been a lot of studies
crease the risk for the incidence of infectio- conducted on mothers who give birth at a
us diseases, reduce intelligence and for long young age and its risk for stunting among
term it can increase the risk for non- children, however they do not discuss it
communicable diseases (Soliman et al., comprehensively. This study will analyze
2021). Stunted children suffers from cogni- the impact of giving birth at a young age on
tive development reduction by 7% compa- the incidence of stunting in children who
red to those who are not stunted (Ekholue- are born based on literatures/ articles
netale et al., 2020). The condition of stun- published in journals.
ting in children is associated with impaired
fat oxidation which is a risk factor for obe- SUBJECTS AND METHOD
sity. It generates obesity during adolescen- 1. Study design
ce and adulthood. The obesity will increase This study is a systematic review. The
the risk for non-communicable diseases search for articles was carried out syste-
(Hoffman et al., 2000). matically and comprehensively by using
The incidence of stunting is associat- several databases consisting of: PubMed,
ed with the first 1000 days of life. Many Ebsco, Google Scholar and SpringerLink.
factors may contribute, including maternal The search for the articles was not limited
knowledge, maternal height less than 150 by the year of publication of July 2022. The
cm, maternal body mass index (BMI) < 18.5 keywords used in the article search include-
kg/m 2 , birth weight < 2.5 kg, the existence ed "risk factor" OR “determinant” AND
of two or more toddlers in one house, and “stunting” AND "young maternal age" OR
diet diversity and repeated diarrheal episo- "adolescent mother*" OR "teen mother*"
des are also risk factors for stunting (Berhe OR "adolescent pregnancy" OR "teen preg-
et al., 2019). Maternal factors related to the nancy" AND "logistic regression" OR
incidence of stunting include maternal age. “multivariate”.
Mothers who marry, become pregnant and 2. Population and sample
give birth at a young age may give impacts The study used PICO (Population-Interven-
on the growth of children (Wells et al., tion-Comparative-Outcomes) approach as a
2022). A study conducted in 18 countries in reference for the criteria for articles includ-
Asia, Africa, and Latin America reveals that ed in the systematic review. Population in
in 3 out of 7 countries in Asia and 6 out of 9 this study was children. Intervention was
countries in Africa there is an effect of gestational age in mothers <20 years. Com-
mothers who become pregnant and give parative was gestational age ≥20 years.
birth at a young age toward height restricti- Outcomes was stunting events.
on of children aged 0-11 month. Moreover, 3. Inclusion criteria
in all countries observed, poorer growth Inclusion criteria for the articles included
continued after 24 months among children in the review were research articles that
whose mothers are younger (Yu et al., discussed the history of maternal age
2016). A study shows that giving birth at during pregnancy and the incidence of
the age of 20-30 years may reduce the risk stunting in children, the study was primary
for stunting in children by 81% compared research, used an analytical observational
to giving birth at the age of <20 years research design, were presented in English
(aOR= 0.09; 95% CI= 0.03 to 0.29) and Indonesian.

www.thejmch.com 480
Astuti et al./ Maternal Age Correlates with Stunting in Children

4. Exclusion criteria 7. Data Analysis

Exclusion criteria were the study was not Data were analyzed by comparing the risk
primary research, the article could not be value of stunting in each region. The value
accessed in full text version, and was not of significant correlations were obtained
PICO-compliant. from the value of confidence interval that
5. Operational definition of variable did not exceed zero.
Stunting is a condition of chronic malnu-
trition which is indicated by lower height RESULTS
compared to the average stature of his/ her The search for articles obtained 1,048
age, based on the Z score. articles from the PubMed, Ebsco, Google
Maternal age during pregnancy is the Scholer and SpringerLink databases. 193
age when a mother is pregnant with an duplications of titles were excluded. After
offspring/ offsprings. conducted the screening process and the
6. Instrument feasibility assessment according to the cri-
The study used a cross sectional study teria, the study obtained 113 articles. The
design assessment checklist from CEBMa full text version of those articles were sub-
(center for evidence-based management) to sequently assessed. 9 articles were obtained
assess the quality of articles to be included to be included into the review. The process
in the review. of search up to selecting to be included in
the review is presented in Figure 1.
Identification

Identified articles from Duplication articles were

database (n = 1.048) removed

Articles excluded (n = 742)

Non- full-text (n = 76)
Selected articles
Non-English or Indonesian (n = 7)
Screening

(n = 855) Irrelevant title (n = 659)

Full-text version of the articles were

Eligible Full-text version excluded for: (n = 104)
(n = 113) The research method was not
Eligibility

observational (n = 16)
Intervention was irrelevant (n = 46)
Outcome was irrelevant (n = 42)

Articles included into

systematic reviews
Inclusion

(n = 9)

Figure 1. Flow chart from the process of article

search up to being included in the review

www.thejmch.com 481
Astuti et al./ Maternal Age Correlates with Stunting in Children

The description of the articles included in the systematic review is presented in Table 1.

Table 1. Descriptions of articles that qualify for systematic reviews.

Author Study Effect Maternal Child Sample
No Title Country Data source
(Year) Design Measures Age Age size
1 Akpinar Adolescent Motherhood and Turkey Cross- aOR 15-19; 20- 0-59 2102 Turkey
and Negative Birth Outcomes, sectional (adjusted 49 (ref) months Demographic
Teneler Stunting and Social odds ratio) and Health
(2022) Determinants: Secondary Survey (TDHS)
Analysis of Turkish National 2018
Data 2018
2 Gonfa Determinant Factors of Child Ethiopia Cross- aOR 15-19 (ref); 0-59 719 Households with
(2013) Malnutrition in Ambo Town sectional 20-24; 25- months children aged 0-
Oromia Region (The Case of 29; 30-34; 59 months in
Ambo Town) 35-39; 40- Ambo Town
44; 45-49
3 Degarege Undernutrition and Ethiopia Cross- aOR <20 (ref); 5-14 459 School-age
et al. associated risk factors among sectional 20-30; >30 years old children living in
(2015) school age children in Addis Woreda (district)
Ababa, Ethiopia 8, Lideta Sub-
City
4 Fall et al. Association between Brazil, Cohort aOR 19; 20-24 2 years 13199 Consortium for
(2015) maternal age at childbirth Guatemala, (ref); 25- Health Oriented
and child and adult outcomes India, 29; 30-34; Research in
in the off spring: a Philippines, 35 Transitioning
prospective study in five low- and South Societies
income and middle-income Africa (COHORTS)
countries (COHORTS
collaboration)
5 Mtongwa A comparative analysis of Tanzania Cross- aOR 15-19 (ref); <5 years 8852 Tanzania
et al. determinants of low birth sectional 20+ Demographic
(2021) weight and stunting among and Health
under five children of Survey
adolescent and non-
adolescent mothers using
2015/16 Tanzania
Demographic and Health
Survey (TDHS)

www.thejmch.com 482
Astuti et al./ Maternal Age Correlates with Stunting in Children

Author Study Effect Maternal Child Sample

No Title Country Data source
(Year) Design Measures Age Age size
6 Tariq et Factors Associated with Pakistani Cross- aOR 13-17; 18- <2 years 984 Pakistan
al. (2018) Undernutrition in Children sectional 22; 23-27; Demographic
under the Age of Two Years: ≥28 and Health
Secondary Data Analysis Survey 2012-
Based on the Pakistan 2013
Demographic and Health
Survey 2012–2013
7 Yiga Child Growth and Burundi Cross- aOR 15-24 (ref); 6-24 6158 Health centers
(2016) Determinant Factors A Case sectional 25-34; 35- months from all
Study of Burundi 49 provinces in
Burundi except
Bujumba Mairie
8 Yang et Trends and determinants of Uganda Cross- aOR 15-19; 20- <5 years 14747 Uganda
al. (2018) stunting among under-5s: sectional 30; 31-49 Demographic
evidence from the 1995, (ref) and Health
2001, 2006 and 2011 Uganda Surveys (UDHS)
Demographic and Health 1995, 2001, 2006
Surveys and 2011
9 Wemakor Young maternal age is a risk Ghana case-control aOR 15-17; 18- <5 years Cases Reports of high
et al. factor for child 19; ≥20 (n=150) prevalence of
(2018) undernutrition in Tamale Controls teenage
Metropolis, Ghana (n=150) childbearing in
the Metropolis:
Kakpayili,
Bulpiela,
Kalariga and
Kunyevilla

www.thejmch.com 483
Astuti et al./ Maternal Age Correlates with Stunting in Children

Table 2. The result of extraction of articles included in a systematic review based

on maternal age and stunting incidence
No Author Stunting
Study
(Year) Mother's Number Incidence Percentage OR 95% CI/ p
Sample
Age of (%)
Mothers
Akpinar and 15–19 138 12 8.70 0.77 0.36 to 1.64
1 Teneler 2,102
(2022) 20–49 (Ref) 1964 104 5.20
15-19 (Ref) 84 48 57.7 <0.001
20-24 160 88 55.2 0.8926
25-29 144 77 53.5 0.7796
Gonfa
2 719 30-34 121 63 51.9 0.7189
(2013)
35-39 76 36 47.60 0.629
40-44 64 29 45.30 0.4139
45-49 70 28 40.40 0.3114
<20 (Ref) 78 19 24.30
Degarege et
3 459 20 - 30 321 50 15.50 0.09 0.03 to 0.29
al. (2015)
>30 60 21 35.00 0.24 0.04 to 1.40
≤19 1.37 1.20 to 1.56
20-24 (Ref) 1.00
Fall et al.
4 13199 25 - 29 13199 5296 40.12 0.84 0.76 to 0.93
(2015)
30-34 0.93 0.83 to 1.04
≥35 1.18 1.03 to 1.35
Mtongwa et 15 -19 (Ref) 600 183 30.60 1.00
5 8852
al. (2021) >20 8252 2820 34.20 0.97 0.73 to 1.29
13 - 17 161 10 6.20 3.42 1.61 to 7.20
Tariq et al. 18 - 22 500 73 14.60 2.30 1.13 to 4.60
6 984
(2018) 23 - 27 257 16 6.40 1.90 0.90 to 3.80
28(Ref) 66 1 1.00 1.00
15 -24 1925 1000 52.00 0.97 0.84 to 1.13
7 Yiga (2016) 6158 25 – 34 (Ref) 3033 1577 52.00 1.00
35 - 49 1200 672 56.00 1.17 0.98 to 1.39
15 - 19 1053 446 42.35 1.57 1.31 to 1.87
Yang et al.
8 14747 20 -30 8923 3777 42.32 1.18 1.08 to 1.29
(2018)
31 – 49 (Ref) 4771 1928 40.41 1.00
15 - 17 43 9.97 4.20 to 23.65
Wemakor et 18 - 19 107 7.08 3.85 to 13.00
9 300
al. (2018) all 15- 19 150 89 59.30 7.56 4.20 to 13.63
20 (Ref) 150 25 16.70 1

For the assessment of the articles included unmet question. The results of the assess-
in the review, the study used the reference ment obtained values that ranged from 9-12
for article quality assessment from CEBMa that met the quality.
with observational study design. Quality The study obtained articles discussing
assessment was conducted with 12 points of maternal age during pregnancy and the
questions. One point was given for each incidence of stunting, namely 9 articles from
question met and zero was given for each Turkey, 2 articles from Ethiopia, Tanzania,

www.thejmch.com 484
Astuti et al./ Maternal Age Correlates with Stunting in Children

Pakistan, Ghana, Uganda, Burundi and 1 (Yang et al., 2018). Furthermore, there was
article covering Brazil, Guatemala, India, an article which revealed that the older the
Philippines, and South Africa. The results of mother, the lower the risk of stunting. The
the review of the article discovered the incidence of stunting decreased by 70% in
prevalence of stunting in Brazil was 667 mothers aged 45-49 years compared to
(13.8%), Guatemala 858 (79.5%), India 1841 mothers aged 15-19 years (Gonfa, 2013)
(49.8%), Philippines 1558 (62.2%), and
South Africa 372 (20.6%) (Fall et al., 2015). DISCUSSION
The prevalence of stunting in Uganda Based on the articles reviewed the highest
based on demographic survey data from prevalence of stunting was discovered in
1995, 2001, 2006 and 2011 respectively was Guatemala region. Results of several other
44.8%, 44.2%, 37.1% and 33.2%,.(Yang et surveys indicates the prevalence of the area
al., 2018). In Ambo Town area, Oromia are 68.5% in 1995 and 64.5% in 2014
region, Ethiopia, the prevalence of stunting (Gatica-Domínguez et al., 2019). This figure
in children under five was 51.3%. Stunting that is not much different from the result of
issue turned out to be the highest compared other studies. While the two regions in
to wasting and underweight cases (Gonfa, Ethiopia, based on the articles obtained,
2013). In Lideta sub-city, Addis Ababa, indicated much different prevalences. It is
Ethiopia, it was discovered that 19.6% of possibly due to differences in economic
stunting occurred in children (Degarege et levels or rural and urban areas resulting in
al., 2015) . differences in stunting prevalence (Degare-
The prevalence of stunting in children ge et al., 2015). Moreover, areas with a high
from a study in Turkey was 5.5%(Akpinar & prevalence are areas with food insecurity
Teneler, 2022). The incidence of stunting in (Gatica-Domínguez et al., 2019).
adolescent mothers compared to non-ado- The trend of stunting cases has
lescent mothers in Tanzania was 30.6% and decreased from year to year. The review
34.2%. (Mtongwa et al., 2021). In Burundi indicated a declining trend of stunting in
the prevalence of stunting in children was Uganda region. Based on WHO data, the
53% (Yiga, 2021). incidence of stunting has decreased,
Based on Table 2, it is revealed that however better efforts are still needed to
pregnant women aged <20 were at a greater achieve the target in 2030. The global
risk for stunting than mothers aged ≥ 20 prevalence of stunting in 2020 is 22.0%.
years (OR= 1.37 to 7.56). Women of younger Regions with the most cases are Asia and
age were at a greater risk (maternal age 15- Africa (UNICEF/ WHO/ WORLD BANK,
17 years OR= 9.97 and 18 – 19 years OR= 2021) .
7.56) (Wemakor et al., 2018) , (Age 13 – 17 This study indicated that adolescent
years OR= 3.42 and 18 – 22 years OR= 2.3) mothers aged < 20 years were at a higher
(Tariq et al., 2018). Age 13-17 were at a risk for the incidence of stunting than
greater risk for stunting. mothers aged over 20 years. Moreover, the
There are 2 articles about women aged increased risk for stunting will be greater in
20 - 34 with an odds ratio of 0.09 to 0.93 younger mothers. Age 13 – 17 had odds of
and was statistically significant (Degarege et 3.42 to 9.97. Similar results are revealed by
al., 2015) ,(Fall et al., 2015). However, after other studies that use demographic and
the age of 35, the odds of stunting increased health survey data from 61 countries. The
in OR= 1.18 (Fall et al., 2015), OR= 1.17 risk of stunting increases by 50% from the

www.thejmch.com 485
Astuti et al./ Maternal Age Correlates with Stunting in Children

maternal age of 13 years and will decrease born to adolescent mothers are shorter
gradually by 20% until maternal age is 27 than children born to adult mothers. After
years (Danaei et al., 2016) (Finlay et al., one year period the incidence of stunting in
2011). The increased risk for stunting would adolescent mothers is 8% and adult mothe-
occur again at the maternal age of 35 years rs is 7% (Le Roux et al., 2019).
in accordance with the results of the review Factors that influence the incidence of
with OR = 1.18(Fall et al., 2015) , OR=1.17 stunting in adolescent mothers are greater
(Yang et al., 2018) . This trend also occurs because the economic level of adolescent
in the study conducted in 55 countries mothers tends to be lower than that of adult
(Finlay et al., 2011). mothers. In addition, exclusive breastfeedi-
Children who were born to young ng can be a protective factor toward stunti-
mothers have the potential for poor health ng. In adolescent mothers, exclusive breast-
conditions. In addition, the possibility of feeding is lower than in adult mothers (Le
other diseases is greater than in older Roux et al., 2019).
mothers. Anemia, underweight, diarrhea,
infant mortality, and wasting are conditions AUTHOR CONTRIBUTION
that may occur in children born to young FDA as a researcher contributed in draf-
mothers (Finlay et al., 2011). The incidence ting, reviewing articles and writing manu-
of stunting is not only affected by maternal scripts. AA contributed in article search,
age at the time of delivery, but also a lot of article assessment and data extraction. RR
other factors such as knowledge, social and contributed in reviewing and editing the
economic factors (Akpinar and Teneler, manuscript.
2022). The results of other studies indicate
that young mothers have low economic FUNDING AND SPONSORSHIP
conditions or come from poor families, and This research was funded by the re-
lack of knowledge due to dropping out of searchers themselves.
school. Children with early menarche have
a relatively long adolescence period, the CONFLICT OF INTERESTS
absence of parental guidance will lead them There is no conflict of interest in this study.
to promiscuity that evokes unwanted preg-
nancies.(Branson et al., 2015) . ACKNOWLEDGMENT
In addition, pregnancy during adole- The researcher would like to thank the
scence requires more energy and nutrients PubMed, Ebsco, Google Scholar and Spri-
both for mother and the offspring. Adole- ngerLink databases for providing articles
scence is the period of psychological, sexu- for this research.
al, neurological, and behavioral develop-
ment that requires more energy and nu- REFERENCES
trients. Pregnancy during adolescence leads Akpinar CV, Teneler AA (2022). Adolescent
to a struggle for nutrition between the mo- motherhood and negative birth outco-
ther and the fetus she is carrying. It genera- mes, stunting and social determinan-
tes nutritional deficiency condition that ts: secondary analysis of turkish na-
results in low birth weight or other con- tional data 2018. 1–13. http://dx.doi.-
ditions that is potentially impactful in the org/10.21203/rs.3.rs-1410546/v1
future (Nguyen et al., 2021). The results of Berhe K, Seid O, Gebremariam Y, Berhe A,
the cohort study indicates that children Etsay N (2019). Risk factors of stun-

www.thejmch.com 486
Astuti et al./ Maternal Age Correlates with Stunting in Children

ting (chronic undernutrition) of child- Finlay JE, Özaltin E, Canning D (2011). The
ren aged 6 to 24 months in Mekelle association of maternal age with infa-
City, Tigray Region, North Ethiopia: nt mortality, child anthropometric fai-
An unmatched case-control study. lure, diarrhoea and anaemia for first
PLoS ONE, 14(6), 1–11. https://doi.- births: Evidence from 55 low- and mi-
org/10.1371/journal.pone.0217736 ddle-income countries. BMJ Open,
Branson N, Ardington C, Leibbrandt M 1(2). https://doi.org/10.1136/bmjop-
(2015). Health outcomes for children en-2011-000226
born to teen mothers in Cape Town, Gatica-Domínguez G, Victora C, Barros
South Africa. Economic Development AJD (2019). Ethnic inequalities and
and Cultural Change, 63(3), 589–616. trends in stunting prevalence among
https://doi.org/10.1086/679737 Guatemalan children: an analysis usi-
Danaei G, Andrews KG, Sudfeld CR, Fink ng national health surveys 1995-2014.
G, McCoy DC, Peet E, Sania A, et al. Int J Equity Health, 18(1), 110. https:-
(2016). Risk factors for childhood //doi.org/10.1186/s12939-019-1016-0
stunting in 137 developing countries: Gonfa AA (2013). Determinat factors of chi-
a comparative risk assessment analy- ld malnuration in ambo town oromia
sis at global, regional, and country le- region (the case of ambo town). 1(10-
vels. In PLoS Medicine. 13(11). https:- 9100773). Indhria Ganhd National
//doi.org/10.1371/journal.pmed.1002 Open University.
164 Hoffman DJ, Sawaya AL, Verreschi I,
Degarege D, Degarege A, Animut A (2015). Tucker KL, Roberts SB (2000). Why
Undernutrition and associated risk are nutritionally stunted children at
factors among school age children in increased risk of obesity? Studies of
Addis Ababa, Ethiopia Global health. metabolic rate and fat oxidation in
BMC Public Health, 15(1), 1–9. https:- shantytown children from Sao Paulo,
//doi.org/10.1186/s12889-015-1714-5 Brazil. Am J Clin Nutr, 72(3), 702–
Ekholuenetale M, Barrow A, Ekholuenetale 707. https://doi.org/10.1093/ajcn/7-
CE, Tudeme G (2020). Impact of stun- 2.3.702
ting on early childhood cognitive deve- Le Roux K, Christodoulou J, Stansert-
lopment in Benin: evidence from Katzen L, Dippenaar E, Laurenzi C, Le
Demographic and Health Survey. Gaz Roux IM, Tomlinson M, Rotheram-
Egypt Pediatr Assoc. 68(1). https://do- Borus MJ (2019). A longitudinal co-
i.org/10.1186/s43054-020-00043-x hort study of rural adolescent vs adult
Fall CHD, Sachdev HS, Osmond C, Restre- South African mothers and their chil-
po-Mendez MC, Victora C, Martorell dren from birth to 24 months. BMC
R, Stein AD, et al. (2015). Association Pregnancy Childbirth, 19(1), 1–8.
between maternal age at childbirth https://doi.org/10.1186/s12884-018-
and child and adult outcomes in the 2164-8
offspring: A prospective study in five Mtongwa RH, Festo C, Elisaria E (2021). A
low-income and middle-income coun- comparative analysis of determinants
tries (COHORTS collaboration). The of low birth weight and stunting amo-
Lancet Global Health, 3(7), e366– ng under five children of adolescent
e377. https://doi.org/10.1016/S2214- and non-adolescent mothers using
109X(15)00038-8 2015/16 Tanzania Demographic and

www.thejmch.com 487
Astuti et al./ Maternal Age Correlates with Stunting in Children

Health Survey (TDHS). BMC Nutr, (2022). Associations of maternal age at

7(1), 1–10. https://doi.org/10.1186/s- marriage and pregnancy with infant
40795-021-00468-6 undernutrition: Evidence from first‐ti-
Nguyen PH, Scott S, Khuong LQ, Pramanik me mothers in rural lowland Nepal.
P, Ahmed A, Rashid SF, Afsana K, Am J Phys Anthropol, January, 557–
Menon P (2021). Adolescent birth and 573. https://doi.org/10.1002/ajpa.24-
child undernutrition: an analysis of 560
demographic and health surveys in Wemakor A, Garti H, Azongo T, Garti H,
Bangladesh, 1996–2017. Ann. N. Y. Atosona A (2018). Young maternal age
Acad. Sci, 1500(1), 69–81. https://- is a risk factor for child undernutrition
doi.org/10.1111/nyas.14608 in Tamale Metropolis, Ghana. BMC
Soliman A, De Sanctis V, Alaaraj N, Ahmed, Res. Notes, 11(1), 1–5. https://doi.org-
S, Alyafei F, Hamed N, Soliman N /10.1186/s13104-018-3980-7
(2021). Early and long-term conse- World Health Organization (2020). Levels
quences of nutritional stunting: From and trends in child malnutrition: Key
childhood to adulthood. Acta Biomed, findings of the 2020 Edition of the
92(1), 1–12. https://doi.org/10.2375- Joint Child Malnutrition Estimates.
0/abm.v92i1.11346 Geneva: WHO, 24(2), 1–16.
Tariq J, Sajjad A, Zakar R, Zakar MZ, Yang YY, Kaddu G, Ngendahimana D,
Fischer F (2018). Factors associated Barkoukis H, Freedman D, Lubaale
with undernutrition in children under YAM, Mupere E, Bakaki PM (2018).
the age of two years: Secondary data Trends and determinants of stunting
analysis based on the Pakistan demo- among under-5s: Evidence from the
graphic and health survey 2012–2013. 1995, 2001, 2006 and 2011 Uganda
Nutrients, 10(6), 1–20. https://doi.- Demographic and Health Surveys.
org/10.3390/nu10060676 Public Health Nutr, 21(16), 2915–
UNICEF/ WHO/ WORLD BANK (2021). 2928. https://doi.org/10.1017/S1368-
Levels and trends in child malnutrition 980018001982
UNICEF/ WHO/ World Bank Group Yiga P (2021). Child growth and determi-
Joint Child Malnutrition Estimates nant factors a case study of burundi
Key findings of the 2021 edition. Wor- (Issue June 2016). Universiteit Gent.
ld Health Organization, 1–32. https://- Yu SH, Mason J, Crum J, Cappa C, Hotch-
www.who.int/publications/i/item/978 kiss DR (2016). Differential effects of
9240025257 young maternal age on child growth.
Wells JCK, Marphatia AA, Cortina‐Borja M, Glob Health Act, 9(1), 1–13. https://-
Manandhar DS, Reid AM, Saville NM doi.org/10.3402/gha.v9.31171

www.thejmch.com 488