Geographic altitude and prevalence of underweight, stunting and wasting in newborns with the INTERGROWTH-21st standard.

OBJECTIVE: To assess the prevalence and risks of underweight, stunting and wasting by gestational age in newborns of the Jujuy Province, Argentina at different altitude levels.

METHODS: Live newborns (n=48,656) born from 2009-2014 in public facilities with a gestational age between 24+0 to 42+6 weeks. Phenotypes of underweight (<P3weight/age), stunting (<P3length/age) and wasting (<P3body mass index/age) were calculated using INTERGROWTH-21st standards. Risk factors were maternal age, education, body mass index, parity, diabetes, hypertension, preeclampsia, tuberculosis, prematurity, and congenital malformations. Data were grouped by the geographic altitude: ≥2000 or <2000m.a.s.l. Chi-squared test and a multivariate logistic regression analysis were performed to estimate the risk of the phenotypes associated with an altitudinal level ≥2000m.a.s.l.

RESULTS: The prevalence of underweight, stunting and wasting were 1.27%, 3.39% and 4.68%, respectively, and significantly higher at >2000m.a.s.l. Maternal age, body mass index >35kg/m2 , hypertension, congenital malformations, and prematurity were more strongly associated with underweight rather than stunting or wasting at ≥2000m.a.s.l.

CONCLUSIONS: Underweight, stunting, and wasting risks were higher at a higher altitude, and were associated with recognized maternal and fetal conditions. The use of those three phenotypes will help prioritize preventive interventions and focus the management of fetal undernutrition.