(OR10-04-26) Prevalence of Infant Wasting More Closely Conforms With Age to Maternal Patterns of Thinness: A Geospatial Secondary Analysis in Rural NW Bangladesh

Sunday, July 26, 2026

11:06 AM - 11:18 AM ET

Location: Maryland Ballroom C

Emerging Leaders in Nutrition Science Poster Competition

Presenting Author(s)

Mary E. de Boer, PhD, MSc (she/her/hers)

Postdoctoral Fellow
Stanford University
Stanford, California, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

FC

Frank C. Curriero

Johns Hopkins University, United States
AT

Andrew L. Thorne-Lyman, ScD MHS

Associate Professor
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States
AS

Abu Ahmed Shamim

BRAC University James P Grant School of Public Health, Bangladesh
RH

Rezwanul Haque, DCS, MA

JiVitA Project Bangladesh
Gaibandha, Rangpur, Bangladesh
BD

Brian Dyer

Johns Hopkins University, United States
PC

Parul Christian, PhD, MSc

Professor
Johns Hopkins University
Baltimore, Maryland, United States
AL

Alain Labrique

World Health Organization, Switzerland
Keith P. West, Jr., DrPH, MPH (he/him/his)

George G. Graham Professor of Infant and Child Nutrition
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

Disclosure(s):

Mary E. de Boer, PhD, MSc: No relevant financial relationship(s) with ineligible companies to disclose.

Keith P. West, DrPH, MPH, Jr.: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: To examine spatial relationships between maternal nutritional status (MUAC) and infant wasting trajectories from birth through 12 months in rural Bangladesh

Methods: Cross-sectional panels of weight for length z-score (WLZ) data at birth, 1, 3, 6 and 12 mo of age were analyzed in relation to maternal mid-upper arm circumference (MUAC) early in pregnancy for 7,731 singleton mother-infant pairs with geolocation data collected during the JiVitA-3 prenatal micronutrient supplement trial in NW Bangladesh (2008-12). The rural area comprised 435 sq km, bounded to the east by the Teesta River, becoming slightly more developed toward the west. Women with MUAC < 21.5 cm at enrollment (median ~9 wk gestation) were classified thin and infants with WLZ < -2 by WHO growth standards were classified wasted at each age. Using R, spatial intensity ratio maps (based on kernel density estimation) depicted the spatial variation in maternal thinness and infant wasting. Using ArcGIS, natural breaks were identified in the maternal MUAC distribution, defining five longitudinal zones (Z) across the study area. Within each, the prevalence of WLZ < -2 for infants was calculated at each age. GEE logistic regressions were applied, controlling for maternal education, to adjust for SES, and clustered trial design, to estimate interaction odds ratios (ORi) between zone at each infant age for WLZ < -2.

Results: A maternal nutritional gradient emerged where Z1 (west) had the lowest prevalence of thinness (12%; 95% CI: 10-14%), monotonically rising to 26% (23-28%) in Z5 (east, nearest the river). In newborns, wasting varied by zone and a gradient was indiscernible, but within older age bands, infant wasting resembled maternal geospatial thinness. Between 6 and 12 mo, prevalence of infant wasting doubled in all zones (18-21% vs 8-11%, respectively) and the WLZ < -2 trend aligned geospatially with that for maternal thinness. At 6 mo, infants in Z5 were 78% more likely to be wasted than in Z1 (ORi: 1.78, 1.20-2.64), a disparity that persisted to12 months (ORi: 1.69, 1.19-2.40).

Conclusions: In a contiguous rural area of Bangladesh, controlling for maternal SES, patterns of infant wasting converged with age toward a maternal geospatial gradient in thinness, implicating environmental determinants beyond the household.

Funding Sources: Gates Foundation