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Does birth season correlate with childhood stunting? An input for astrological nutrition

BMC Pediatrics volume 22, Article number: 306 (2022) Cite this article

Abstract

Introduction

Chronic malnutrition is highly prevalent in Sub-Saharan Africa and a severe public health problem in Ethiopia.At country level in the past three decades,the prevalence of stunting is above 40%.Different researchs and intervention were implemented in the past;but the progresss is non-remarkable.Despite; the effect of birth season on childhood chronic malnutrition was not studied yet in Ethiopia.

Methods

This research was extracted from the 2016 demographic health survey of Ethiopia. The data was collected based on national and international scientific protocols. A total of 645 enumeration areas were selected for the national survey.The surevey uses two stage stratified sampling technique to gather data from the sampling unit. After excluding non eligible children a total of 8855 participants were included for final analysis.Height and weight were measured based on the standards nutritional assessment procedure.SPSS version 20 was used to analyze the data.Descriptive statistics were used to present the data. Binary and multivariable logistic regression models were regressed to identify the potential predictors.A p-value of less than 0.05 with 95% CI were used to declare an association.

Result

The prevalence of stunting in Ethiopia was 38.7% (95% CI: 36.8, 40.6). Season of birth had a significant association with stunting. The odds of being stunted among children born in the spring season were decreased by 16% as compared to children born in the winter season.

Conclusion

Children born in the spring season were less likely to be stunted (the so called October effect). The clear scientific relation between the season of birth and child anthropometric indicator is not well understood. Nutritional interventions and policies are better to consider the birth season of the child.

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Background

Malnutrition is a global public health problem that affects the entire population. In the twenty-first century, the rates of under-nutrition and over-nutrition increased unpredictably. Unexpectedly developing countries suffered from a double burden of malnutrition the so-called “DBM” at an individual, household, and community level [1, 2].

Undernutrition is a major public health problem among adolescents,children under-five years, and pregnant and lactating women in developing countries due to the vicious pattern of the problem. Majorly the problem is highly prevalent in Sub-Saharan Africa [3,4,5,6].

Stunting is a form of chronic malnutrition in under-five children which is expressed in percent of median, Z-score, and percentiles. Based on the World Health Organization (WHO) cut-off value stunting is classified when the Z-score value is less than -2 [7].

Globally;21.3% of children under five years were stunted [3], of this 30% of them were in Sub-Saharan Africa.There is a little bit epidemiological reduction in the region [8, 9]. In the last two decades; there was observable stunting reduction in Ethiopia [10, 11]. Based on 2016, Ethiopia Demographic Health Survey (EDHS) report the prevalence of stunting was 38% and in the northern regions (highland areas) of Ethiopia (Tigray, Afar, and Amhara) stunting prevalence is above 40% which is greater than the national level [11].

The consequence of stunting is beyond the child's health. It had social, economic, political, and health crises. Nationally Ethiopia costs about 16.5% of Gross Domestic Product per annum due to malnutrition [12]. Some of the health consequences of stunting are decreased intelligence ability and secondary malnutrition (late adulthood metabolic syndrome) [13].

Generally, the determinant factors and causes of stunting are interrelated and complex. It is a known fact that a bunch of researchers identified maternal, health-related, nutritional and sociodemographic factors [3,4,5, 8, 9, 13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49]. Even though a lot of research was conducted before in Ethiopia and worldwide the determinant factors explored and the methodology were almost similar. Surely, in Ethiopia, the effect of birth season on childhood malnutrition was not studied before. The government and different stakeholders put their effort to reduce malnutrition; although the progress is not satisfactory [50]. There is low energy and nutrient intake in the summer season due to temporal food insecurity (hunger) in Ethiopia [51].To know the effect of season on the nutritional status of children the current type of study is fundamental.

As a result, we intend to assess the effect of the season of birth on stunting in Ethiopia nationally.

Materials and methods

Study setting and design

The 2016 EDHS was designed to provide up-to-date estimates of key demographic and health indicators in Ethiopia. The data was collected from nine regions and two city administrations every five years.A detailed description of the study design and methodology the 2016 is found elsewhere [52].In brief; a stratified two-stage random sampling design was used to collect data from a nationally representative sample. In the first stage, a total of 645 Enumeration Areas (EA) (202 in urban areas and 443 in rural areas) were selected with probability proportional to EA size and with independent selection in each sampling stratum. In the second stage, a fixed number of 28 households per cluster were selected with an equal probability of systematic selection from the newly created household listing. A total of 10,752 children under the age of 5 years were eligible for length/height and weight measurements in the 2016 EDHS, who are born in the last 5 years before the survey.Weight measurements were obtained using light weight SECA scales with a digital screen designed and manufactured under the guidance of UNICEF. Height measurements were carried out using a Shorr measuring board. Children younger than 24 months were measured for height while lying down position, and older children were measured in standing position. Wealth index of households are given scores based on the number and kinds of consumer goods they own, ranging from a television to a bicycle or car, in addition to housing characteristics such as source of drinking water, toilet facilities, and flooring materials. These scores are derived using principal component analysis.We excluded children with missing data on the question related to the outcomes of interest and other covariates adjusted in the multivariable model. We include a total of 8855 children under-five years for finaly analyses (Fig. 1) [52].

Fig. 1
figure 1

The flow diagram of the study participant’s selection

Full size image

Outcome of interest

The outcome of interest was stunting which was assessed by measuring the height/length and age of the children. The outcome variable was categorized as stunted and non-stunted. Stunting is classified based on WHO Z-Score value; children having a Z-Value < -2 are considered as stunted and all children having a Z-Value ≥ -2 was categorized as non-stunted [52].

Exposure variable

Season of birth classification was taken from Ethiopian Metrological Data. In Ethiopia context, there are four major seasons; spring, winter, autumn, and summer. In each season three months were incorporated. In the spring (September, October, and November), winter (December, January, and February), autumn (March, April, and May), and summer(June, July, and August). Majorly all regions in Ethiopia get annual rains in the summer season (the wet season)(June, July and august). All other seasons are almost dry season [53].

Covariates

Based on the previous research findings, the following covariates were selected: cigarette smoking history of the mother, father's education status, household wealth index, anemia level of the mother, women occupation type, residence, source of drinking water, type of toilet facility, mothers weight, mothers height, antenatal care visit history and birth interval.

Statistical analysis

SPSS version 20 was used to analyze the data. Descriptive statistics was used to present the study variables. Principal component analysis was used to construct a household wealth index from the total assets in the household. Binary and multivariable logistic regression models were employed to determine the association between birth season and stunting. Crude odds ratios (COR) and Adjusted Odds Ratios (AOR) were presented with 95% confidence intervals. Each covariate was included in the multivariable logistic model regardless of their statistical significance in the binary logistic regression analysis. Finally statistical significance was declared at p-value < 0.05 [54].

Result

The current study assessed the effect of birth season on chronic malnutrition among children underfive yearsin Ethiopia. We included 8855 children under five years from EDHS 2016 dataset. Almost fifty percent (51%) of children under-five years were male in sex and 89.1% of children resided in rural Ethiopia. Seventy-four percent of children’s mothers had antenatal care visits and eight-nine percent of children utilized unimproved toilet type (Table 1).

Table 1 Sociodemographic and behavioral characteristics of study participants (N = 8855)
Full size table

Prevalence of stunting in children under-five years

The prevalence of stunting among children under five years was 38.7% (1650) (95% CI: 36.8, 40.6) (Fig. 2).The birth season disaggregated prevalence of stunting was 25.2% in winter,27.7% in spring,25.7% in summer and 21.4% in autumn.

Fig. 2
figure 2

Stunting prevalence in children under five years

Full size image

The association between birth season and stunting (Chronic malnutrition)

In the multivariable logistic regression model, twelve variables were included to control the confounding effect. The birth season had a significant association with stunting both in the binary and multivariable logistic regression model. The odds of being stunted among children born in the spring season were decreased by 16% as compared to children born in the winter season (Table 2).

Table 2 Binary and multivariable logistic regression analysis of birth season and stunting in Ethiopia
Full size table

Discussion

The current study assess the association between birth season and chronic malnutrition (Stunting) extracted from EDHS 2016. The study concluded that there is a significant correlation between birth season and stunting. This is the first study that explored the association between birth season and stunting at the national level in Ethiopia.

Being born in the spring season reduced the occurrence of stunting as compared to children born in the winter season. The current finding is consistent with a study conducted in Ethiopia that assured the weight gain of an infant was high in the spring season [55]. Similarly infants born in the spring season had high velocities in length and weight catch up [56].Another study conducted in Southwest Ethiopia among children briefly shown that the mean weight and height gain was high in spring season [41].

The birth season effect is not only in children anthropometry although it affects the blood cell profiles.As reported in a study conducted in china the hemoglobin concentration was higher in winter-born infants as compared to summer-born infants [57].

Another study conducted in India confirmed that the birth size of offspring depends on the maternal intake of nutrients and physical activities during pregnancy. Both nutrient intake and physical activities of the mother determine the size of the offspring positively or negatively. For example, maternal activity and nutrient intake are high during harvest season for women who are participated in agricultural activity. Additionally, they also reported a winter-born infants had low anthropometric indices as compared to summer-born infants [58].High temperature during the intrauterine period and infancy downgrades the growth of an infant negatively and the consequences crossed to the adulthood period [59]. The birth season does not merely affect the nutritional status of the infant. It had also a significant effect on academic performance [60]. Some scholars correlate the season of birth with Vitamin –D exposure [61]. Moreover; the temperature level at the time of birth season affects the infants' anthropometry due to disruption of Vitamin D synthesis [62].Further more birth season had a significant correlation with cardiovascular, mental, and neurovascular diseases [63, 64].

It is possible to conclude that birth season had a significant impact on children's nutrition profiles based on the aforementioned literatures. The possible reason for the association between spring season and stunting is described as follows; In Ethiopia's context the spring season (also known as harvest season) had a surplus production and availability of fruit and vegetables in the garden, the markets and on the table. Though this physical accessibility of fruit and vegetables increased the chance of consumption for the women at (pregnancy or lactating period). Most fruit and vegetables become fruitful in the spring season. As a result, the women will get an adequate amount of vitamins and minerals; which is crucial for the child's growth and development. Seasonal hunger is common, in most of the country territory summer season is the worst (most households are food insecure) [65, 66].

Children born in hunger season are highly malnourished [67] and food insecured [68]. Empierically it is proved that stunting prevalence was varied in different season as reported from study conducted in Southern Ethiopia [65, 69]. A nationawide study conducted on daily energy intake and household dietary diversity score across months, sepctulate the energy intake and household dietary diversity score incresead from september to march in rural Ethiopia [51]. This research clearly depicted the dietary intake up and downs across season in Ethiopia. Energy intake and household dietary diversiity was inadequate in summer season( June to September).

Climate change is a big deal for global under nutrition especically the figure of undernourished people will increase in non determined folds in the future [70]. Thus climate change affect the nature trends of seasons.

As the second point; women who gave birth in spring will get adequate rest to give care to the child; it is well known that the next consecutive six months after spring season were low workload in rural Ethiopia. Additionally, during the consecutive six months after spring is relatively Ethiopian households were food secured.

In new point of view; malnutrition and disease depend on the lunar cycle and astronomical body movement.Recently different scholars hypothesized that human health,nutrition and solar system are interwoven.So our solar system (the universise) affect our daietary habit and it affect our nutritional status.Indeed day-night length was difreent across seasons;this probably affect the child physiology (growth and development). Actually this astrological effect is not well understood and it needs further investigation [71,72,73].

This research has a number of strengths but it has some limitation for example there is lack of researches in the area conducted before which made the discussion too difficult.

Conclusion

Children born in spring season were less likely to be stunted; the researcher arbitrary called October effect. The clear scientific relation between birth season and child anthropometry is not well understood. For future researcher conducting follow up study and assessing the effect of birth season on childhood nutritional status will be a big assignment.

Availability of data and materials

The data was obtained from the website https://www.idhsdata.org/idhs/news.shtml.

References

  1. Di Cesare M, Soric M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, et al. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med. 2019;17(1):212.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Popkin BM, Corvalan C, Grummer-Strawn LM. Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet. 2020;395(10217):65–74.

    Article  PubMed  Google Scholar 

  3. Vaivada T, Akseer N, Akseer S, Somaskandan A, Stefopulos M, Bhutta ZA. Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline. Am J Clin Nutr. 2020;112(Supplement_2):777S-91S.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Li Z, Kim R, Vollmer S, Subramanian SV. Factors Associated With Child Stunting, Wasting, and Underweight in 35 Low- and Middle-Income Countries. JAMA Netw Open. 2020;3(4):e203386.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Baye K, Laillou A, Chitweke S. Socio-economic inequalities in child stunting reduction in Sub-Saharan Africa. Nutrients. 2020;12(1):253. https://doi.org/10.3390/nu12010253. PMID: 31963768; PMCID: PMC7019538.

  6. Kt R, et al. Nutritional status and its associated factors among school adolescent girls in Adama City, Central Ethiopia. J Nutr Food Sci. 2016;6:1–8.

    Google Scholar 

  7. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl. 2006;450:76–85. https://doi.org/10.1111/j.1651-2227.2006.tb02378.x. PMID: 16817681.

  8. Yaya S, Oladimeji O, Odusina EK, Bishwajit G. Household structure, maternal characteristics and children's stunting in sub-Saharan Africa: evidence from 35 countries. Int Health. 2020:ihz105. https://doi.org/10.1093/inthealth/ihz105. Epub ahead of print. PMID: 31927593.

  9. Roediger R, Hendrixson DT, Manary MJ. A roadmap to reduce stunting. Am J Clin Nutr. 2020;112(Supplement-2):773S-6S.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Central Statistical Agency [Ethiopia], ICF International. Ethiopia Demographic and Health Survey 2011. In: Central Statistical Agency , ICF International, editors. Addis Ababa, Ethiopia Calverton, Maryland, USA2012.

  11. Central Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland: CSA and ICF; 2016.

  12. African Union Commission, NEPAD Planning and Coordinating Agency, UN Economic Commission for Africa, UN World Food Programme. The Cost of Hunger in Africa: Social and Economic Impact of Child Undernutrition in Egypt, Ethiopia, Swaziland and Uganda. Addis Ababa: UNECA; 2014.

  13. Woldehanna T, Behrman JR, Araya MW. The effect of early childhood stunting on children’s cognitive achievements: Evidence from young lives Ethiopia. Ethiop J Health Dev. 2017;31(2):75–84.

    PubMed  PubMed Central  Google Scholar 

  14. Deshmukh PR, Sinha N, Dongre AR. Social determinants of stunting in rural area of Wardha, Central India. Med J Armed Forces India. 2013;69(3):213–7.

    Article  PubMed  Google Scholar 

  15. Tasic H, Akseer N, Gebreyesus SH, Ataullahjan A, Brar S, Confreda E, et al. Drivers of stunting reduction in Ethiopia: a country case study. Am J Clin Nutr. 2020;112(Supplement_2):875S-93S.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Simelane MS, Chemhaka GB, Zwane E. A multilevel analysis of individual, household and community level factors on stunting among children aged 6–59 months in Eswatini: A secondary analysis of the Eswatini 2010 and 2014 Multiple Indicator Cluster Surveys. PLoS One. 2020;15(10):e0241548.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Nahar B, Hossain M, Mahfuz M, Islam MM, Hossain MI, Murray-Kolb LE, et al. Early childhood development and stunting: Findings from the MAL-ED birth cohort study in Bangladesh. Matern Child Nutr. 2020;16(1):e12864.

    Article  PubMed  Google Scholar 

  18. Mengesha HG, Vatanparast H, Feng C, Petrucka P. Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS). BMC Nutr. 2020;6:52.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Locks LM, Patel A, Katz E, Simmons E, Hibberd P. Seasonal trends and maternal characteristics as predictors of maternal undernutrition and low birthweight in Eastern Maharashtra, India. Matern Child Nutr. 2021;17(2):e13087. https://doi.org/10.1111/mcn.13087.

  20. Islam MS, Zafar Ullah AN, Mainali S, Imam MA, Hasan MI. Determinants of stunting during the first 1,000 days of life in Bangladesh: A review. Food Sci Nutr. 2020;8(9):4685–95.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hailu BA, Bogale GG, Beyene J. Spatial heterogeneity and factors influencing stunting and severe stunting among under-5 children in Ethiopia: spatial and multilevel analysis. Sci Rep. 2020;10(1):16427.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Fatima S, Manzoor I, Joya AM, Arif S, Qayyum S. Stunting and associated factors in children of less than five years: A hospital-based study. Pak J Med Sci. 2020;36(3):581–5.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chowdhury TR, Chakrabarty S, Rakib M, Afrin S, Saltmarsh S, Winn S. Factors associated with stunting and wasting in children under 2 years in Bangladesh. Heliyon. 2020;6(9):e04849.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Chidumwa G, Said-Mohamed R, Nyati LH, Mpondo F, Chikowore T, Prioreschi A, et al. Stunting in infancy, pubertal trajectories and adult body composition: the Birth to Twenty Plus cohort, South Africa. Eur J Clin Nutr. 2021;75(1):189–97. https://doi.org/10.1038/s41430-020-00716-1.

  25. Brar S, Akseer N, Sall M, Conway K, Diouf I, Everett K, et al. Drivers of stunting reduction in Senegal: a country case study. Am J Clin Nutr. 2020;112(Supplement_2):860S-74S.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Bogale B, Gutema BT, Chisha Y. Prevalence of Stunting and Its Associated Factors among Children of 6–59 Months in Arba Minch Health and Demographic Surveillance Site (HDSS), Southern Ethiopia: A Community-Based Cross-Sectional Study. J Environ Public Health. 2020;2020:9520973.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Binagwaho A, Rukundo A, Powers S, Donahoe KB, Agbonyitor M, Ngabo F, et al. Trends in burden and risk factors associated with childhood stunting in Rwanda from 2000 to 2015: policy and program implications. BMC Public Health. 2020;20(1):83.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Astatkie A. Dynamics of stunting from childhood to youthhood in Ethiopia: Evidence from the Young Lives panel data. PLoS One. 2020;15(2):e0229011.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Woldeamanuel BT, Tesfaye TT. Risk Factors Associated with Under-Five Stunting, Wasting, and Underweight Based on Ethiopian Demographic Health Survey Datasets in Tigray Region. Ethiopia J Nutr Metab. 2019;2019:6967170.

    PubMed  Google Scholar 

  30. Nepali S, Simkhada P, Davies I. Trends and inequalities in stunting in Nepal: a secondary data analysis of four Nepal demographic health surveys from 2001 to 2016. BMC Nutr. 2019;5:19.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Mohammed SH, Muhammad F, Pakzad R, Alizadeh S. Socioeconomic inequality in stunting among under-5 children in Ethiopia: a decomposition analysis. BMC Res Notes. 2019;12(1):184.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Getaneh Z, Melku M, Geta M, Melak T, Hunegnaw MT. Prevalence and determinants of stunting and wasting among public primary school children in Gondar town, northwest, Ethiopia. BMC Pediatr. 2019;19(1):207.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Gebru TT, Tesfamichael YA, Bitow MT, Assefa NE, Abady GG, Mengesha MB, et al. Stunting and associated factors among under-five children in Wukro town, Tigray region, Ethiopia: a cross sectional study. BMC Res Notes. 2019;12(1):504.

    Article  PubMed  PubMed Central  Google Scholar 

  34. FantayGebru K, MekonnenHaileselassie W, HaftomTemesgen A, OumerSeid A, Afework MB. Determinants of stunting among under-five children in Ethiopia: a multilevel mixed-effects analysis of 2016 Ethiopian demographic and health survey data. BMC Pediatr. 2019;19(1):176.

    Article  CAS  Google Scholar 

  35. Dake SK, Solomon FB, Bobe TM, Tekle HA, Tufa EG. Predictors of stunting among children 6–59 months of age in Sodo Zuria District, South Ethiopia: a community based cross-sectional study. BMC Nutr. 2019;5:23.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Cooper MW, Brown ME, Hochrainer-Stigler S, Pflug G, McCallum I, Fritz S, et al. Mapping the effects of drought on child stunting. Proc Natl Acad Sci U S A. 2019;116(35):17219–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Beal T, Le DT, Trinh TH, Burra DD, Huynh T, Duong TT, et al. Child stunting is associated with child, maternal, and environmental factors in Vietnam. Matern Child Nutr. 2019;15(4): e12826.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Baye K. Prioritizing the Scale-Up of Evidence-Based Nutrition and Health Interventions to Accelerate Stunting Reduction in Ethiopia. Nutrients. 2019;11(12):3065. https://doi.org/10.3390/nu11123065. PMID: 31888177; PMCID: PMC6950157.

  39. Adhikari RP, Shrestha ML, Acharya A, Upadhaya N. Determinants of stunting among children aged 0–59 months in Nepal: findings from Nepal Demographic and health Survey, 2006, 2011, and 2016. BMC Nutr. 2019;5:37.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Geberselassie SB, Abebe SM, Melsew YA, Mutuku SM, Wassie MM. Prevalence of stunting and its associated factors among children 6–59 months of age in Libo-Kemekem district, Northwest Ethiopia; A community based cross sectional study. PLoS ONE. 2018;13(5):e0195361.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  41. Fentahun N, Belachew T, Coates J, et al. Seasonality and determinants of child growth velocity and growth deficit in rural southwest Ethiopia. BMC Pediatr. 2018;18:20. https://doi.org/10.1186/s12887-018-0986-1.

  42. Abeway S, Gebremichael B, Murugan R, Assefa M, Adinew YM. Stunting and Its Determinants among Children Aged 6–59 Months in Northern Ethiopia: A Cross-Sectional Study. J Nutr Metab. 2018;2018:1078480.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Woodruff BA, Wirth JP, Bailes A, Matji J, Timmer A, Rohner F. Determinants of stunting reduction in Ethiopia 2000 - 2011. Matern Child Nutr. 2017;13(2):e12307. https://doi.org/10.1111/mcn.12307. Epub 2016 May 10. PMID: 27161654; PMCID: PMC6866086.

  44. Tariku A, Biks GA, Derso T, Wassie MM, Abebe SM. Stunting and its determinant factors among children aged 6–59 months in Ethiopia. Ital J Pediatr. 2017;43(1):112.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Rakotomanana H, Gates GE, Hildebrand D, Stoecker BJ. Determinants of stunting in children under 5 years in Madagascar. Matern Child Nutr. 2017;13(4):e12409. https://doi.org/10.1111/mcn.12409.

  46. Batiro B, Demissie T, Halala Y, Anjulo AA. Determinants of stunting among children aged 6–59 months at Kindo Didaye woreda, Wolaita Zone, Southern Ethiopia: Unmatched case control study. PLoS One. 2017;12(12):e0189106.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  47. Akombi BJ, Agho KE, Hall JJ, Merom D, Astell-Burt T, Renzaho AM. Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis. BMC Pediatr. 2017;17(1):15.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Dewey KG. Reducing stunting by improving maternal, infant and young child nutrition in regions such as South Asia: evidence, challenges and opportunities. Matern Child Nutr. 2016;12(Suppl 1):27–38.

    Article  PubMed  PubMed Central  Google Scholar 

  49. de Onis M, Branca F. Childhood stunting: a global perspective. Matern Child Nutr. 2016;12(Suppl 1):12–26.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Feldman L, Tubach F, Juliard JM, Himbert D, Ducrocq G, Sorbets E, et al. Impact of diabetes mellitus and metabolic syndrome on acute and chronic on-clopidogrel platelet reactivity in patients with stable coronary artery disease undergoing drug-eluting stent placement. Am Heart J. 2014;168(6):940-7 e7.

    Article  CAS  PubMed  Google Scholar 

  51. Hirvonen K, Taffesse AS, Worku HI. Seasonality and household diets in Ethiopia. Public Health Nutr. 2016;19(10):1723–30.

    Article  PubMed  Google Scholar 

  52. EDHS Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF. 2016. Report No.: 1471–2458 Contract No.: 1.

  53. Fazzini M, Bisci C, Billi P. The Climate of Ethiopia. 2015.

  54. Croft, N. T, Marshall AMJ, Allen CK, al. e. 2018. Guide to DHS Statistics. Rockville, Maryland, USA: ICF; 2018.

  55. Asefa M, Tessema F. Patterns of birth weight at a community level in Southwest Ethiopia. Ethiop J Health Sci. 2004;14(1).

  56. McGrath JJ, Saha S, Lieberman DE, Buka S. Season of birth is associated with anthropometric and neurocognitive outcomes during infancy and childhood in a general population birth cohort. Schizophr Res. 2006;81(1):91–100.

    Article  PubMed  Google Scholar 

  57. Bai Y, Shang G, Wang L, Sun Y, Osborn A, Rozelle S. The relationship between birth season and early childhood development: Evidence from northwest rural China. PLoS ONE. 2018;13(10):e0205281.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Rao S, Kanade AN, Yajnik CS, Fall CH. Seasonality in maternal intake and activity influence offspring’s birth size among rural Indian mothers–Pune Maternal Nutrition Study. Int J Epidemiol. 2009;38(4):1094–103.

    Article  PubMed  Google Scholar 

  59. Isen A, Rossin-Slater M, Walker R. Relationship between season of birth, temperature exposure, and later life wellbeing. Proc Natl Acad Sci U S A. 2017;114(51):13447–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Crawford C, Dearden L, Meghir C. When You Are Born Matters: The Impact of Date of Birth on Educational Outcomes in England1. 2010.

    Google Scholar 

  61. Day FR, Forouhi NG, Ong KK, Perry JR. Season of birth is associated with birth weight, pubertal timing, adult body size and educational attainment: a UK Biobank study. Heliyon. 2015;1(2):e00031.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Strand LB, Barnett AG, Tong S. The influence of season and ambient temperature on birth outcomes: a review of the epidemiological literature. Environ Res. 2011;111(3):451–62.

    Article  CAS  PubMed  Google Scholar 

  63. Longo A, Casuccio A, Pani L, Avitabile T, Cillino S, Uva MG, et al. Association of neovascular age-related macular degeneration with month and season of birth in Italy. Aging (Albany NY). 2016;9(1):133–41.

    Article  Google Scholar 

  64. Poltavskiy E, Spence JD, Kim J, Bang H. Birth Month and Cardiovascular Disease Risk Association: Is meaningfulness in the eye of the beholder? Online J Public Health Inform. 2016;8(2):e186.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Belayneh M, Loha E, Lindtjorn B. Seasonal Variation of Household Food Insecurity and Household Dietary Diversity on Wasting and Stunting among Young Children in A Drought Prone Area in South Ethiopia: A Cohort Study. Ecol Food Nutr. 2021;60(1):44–69.

    Article  PubMed  Google Scholar 

  66. Anna Ferro-Luzzi , Saul S. Morris , Samson Taffesse , Tsegaye Demissie , Maurizio D’Amato. Seasonal Undernutrition in Rural Ethiopia Magnitude, Correlates, and Functional Significance: International Food Policy Research Institute 2001.

  67. Nonterah EA, Welaga P, Chatio ST, Kehoe SH, Ofosu W, Ward KA, et al. Children born during the hunger season are at a higher risk of severe acute malnutrition: Findings from a Guinea Sahelian ecological zone in Northern Ghana. Matern Child Nutr. 2022;18(2):e13313.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Ayele AW, Kassa M, Fentahun Y, Edmealem H. Prevalence and associated factors for rural households food insecurity in selected districts of east Gojjam zone, northern Ethiopia: cross-sectional study. BMC Public Health. 2020;20(1):202.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Aweke CS, Sassi M, Lahiff E, Wordofa MG. Seasonality and food security among smallholder rural households in eastern Ethiopia: evidence from panel data analysis. Res Square. 2020. https://doi.org/10.21203/rs.2.24593/v1.

  70. Janssens C, Havlik P, Krisztin T, Baker J, Frank S, Hasegawa T, et al. Global hunger and climate change adaptation through international trade. Nat Clim Chang. 2020;10:829–35.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Kenneth F, Kiple, Ornelas KC. The Cambridge world history of food. United States of America, New York: Cambridge university press; 2000.

    Google Scholar 

  72. Eileen Nauman. MEDICAL ASTROLOGY. Cottonwood, Arizona1993.

  73. Scott S. Duncan. CJ. Demography and nutrition. USA: Black well publishing company; 2002.

    Google Scholar 

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Authors and Affiliations

  1. Department of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia

    Melese Linger Endalifer

  2. Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia

    Gedefaw Diress

  3. Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia

    Bedilu Linger Endalifer

  4. Department of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia

    Birhanu Wagaye

  5. Department of Public Health Nutrition and Dietetics, College of Medcine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia

    Hunegnaw Almaw

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  1. Melese Linger Endalifer
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  2. Gedefaw Diress
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  3. Bedilu Linger Endalifer
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  4. Birhanu Wagaye
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  5. Hunegnaw Almaw
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Contributions

Melese Linger Endalifer: Conceived and design the study. Melese Linger Endalifer,Gedefaw Diress,Bedilu Linger Endalifer,Birhanu Wagaye and Hunegnaw Almaw:Extract, analyze the data,draft and approve the manuscript.

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Correspondence to Melese Linger Endalifer.

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Ethics approval and consent to participate

The data were downloaded once approval was obtained from Measure DHS. The original DHS data were collected in confirmation with international and national ethical guidelines. The 2016 EDHS protocol was reviewed and approved by the Federal Democratic Republic of Ethiopia Ministry of Science and Technology and the Institutional Review Board of ICF International. Since it is secondary data everyone can access from the website = https://www.idhsdata.org/idhs/news.shtml.

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Authors have no competing interests to declare.

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Linger Endalifer, M., Diress, G., Linger Endalifer, B. et al. Does birth season correlate with childhood stunting? An input for astrological nutrition. BMC Pediatr 22, 306 (2022). https://doi.org/10.1186/s12887-022-03343-w

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Keywords

BMC Pediatrics

ISSN: 1471-2431

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