Correcting for artifactual correlation between misreported month of birth and attained height-for-age reduces but does not eliminate measured vulnerability to season of birth in poorer countries
Project Author
Issue Date
2019-06-10
Authors
Finaret, Amelia B.
Masters, William A.
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Keywords
nutrition smoothing , height-for-age , measurement error , Demographic and Health Surveys , artifactual patterns , seasonality
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Abstract
"Background
Height-for-age z-scores (HAZ) are associated with month of birth (MOB) in many nutrition surveys, but that link could be an artifactual result of measurement error in child birthdates.
Objective
We corrected estimates of the associations between HAZ and MOB for a common type of age misreporting, to measure the remaining seasonality in HAZ and identify country characteristics associated with vulnerability to seasonal changes in early life.
Design
We used nationally representative repeated cross-sections from all available Demographic and Health Surveys (DHS), totaling 1,363,806 children from 218 surveys in 72 countries over 1986–2016, to estimate the seasonal patterns in HAZ by MOB within each survey. Then, we corrected these estimates for each survey's random errors in recorded birth month implied by differences in attained height between children reported as born in December of one year versus January of the next. Indicators of seasonal variation between other months were modeled as functions of national-level incomes using linear regression, and visualizations were constructed using nonparametric local polynomial smoothing regressions.
Results
Over all surveys, misreporting MOB accounted for about one-eighth of the gap in attained height between the worst and best months to be born, which averaged 0.41 HAZ in the raw data and 0.34 HAZ after correction for age misreporting. A linear correction reduced apparent seasonality of HAZ by MOB in 49 of 72 countries, and the remaining nonartifactual differences by season of birth were larger in countries with lower average income per capita.
Conclusions
Measurement error in child MOB helps to explain the association between attained height and seasonal variation in early life environments, but significant seasonality in HAZ by MOB remains in many poor countries. Higher national income is associated with smoother outcomes across birth months, and birth registration efforts would improve nutrition research."
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Global Health Studies
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This is a pre-copyedited, author-produced version of an article accepted for publication in the American Journal of Clinical Nutrition following peer review. The version of record Amelia B Finaret, William A Masters, Correcting for artifactual correlation between misreported month of birth and attained height-for-age reduces but does not eliminate measured vulnerability to season of birth in poorer countries, The American Journal of Clinical Nutrition, Volume 110, Issue 2, August 2019, Pages 485–497, https://doi.org/10.1093/ajcn/nqz111 is available online at: https://academic.oup.com/ajcn/article/110/2/485/5513108
Citation
Amelia B Finaret, William A Masters, Correcting for artifactual correlation between misreported month of birth and attained height-for-age reduces but does not eliminate measured vulnerability to season of birth in poorer countries, The American Journal of Clinical Nutrition, Volume 110, Issue 2, August 2019, Pages 485–497, https://doi.org/10.1093/ajcn/nqz111
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Final manuscript post peer review, without publisher's formatting or copy
editing (postprint)
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Publisher
Oxford University Press