Background Height is regarded as a marker of early-life illness, adversity, nutrition and psychosocial stress, but the extent to which differences in height are determined by early-life socioeconomic circumstances, particularly in contemporary populations, is unclear. This study examined socioeconomic differences in children’s height trajectories from birth through to 21 years of age in four European countries.
Methods Data were from six prospective cohort studies—Generation XXI, Growing Up in Ireland (infant and child cohorts), Millennium Cohort Study, EPITeen and Cardiovascular Risk in Young Finns Study—comprising a total of 49 492 children with growth measured repeatedly from 1980 to 2014. We modelled differences in children’s growth trajectories over time by maternal educational level using hierarchical models with fixed and random components for each cohort study.
Results Across most cohorts at practically all ages, children from lower educated mothers were shorter on average. The gradient in height was consistently observed at 3 years of age with the difference in expected height between maternal education groups ranging between −0.55 and −1.53 cm for boys and −0.42 to −1.50 cm for girls across the different studies and widening across childhood. The height deficit persists into adolescence and early adulthood. By age 21, boys from primary educated maternal backgrounds lag the tertiary educated by −0.67 cm (Portugal) and −2.15 cm (Finland). The comparable figures for girls were −2.49 cm (Portugal) and −2.93 cm (Finland).
Conclusions Significant differences in children’s height by maternal education persist in modern child populations in Europe.
- growth curves
- socio-economic status
- cohort study
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Contributors CM, RL and PV conceived the study. CM and RL wrote the first and successive drafts of the manuscript. NO advised on the statistical approach to modelling. CM modelled and analysed the data. SF, AIR, HB, NK, OR and MK collected the data. All authors revised the manuscript for important intellectual content. CM is responsible for the overall manuscript.
Funding This study is supported by the European Commission (Horizon 2020 grant n° 633666). MK is supported by the UK Medical Research Council (K013351) and NordForsk.
Competing interests None declared.
Ethics approval Multiple cohort studies were involved. Ethical approval with respect to each of the studies is included in the supplementary section.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Cathal McCrory holds all the data that enabled the analysis. He has retained copies of the data on file and the log files that accompany the analysis.The log files are available upon request. The data for Growing Up in Ireland is freely available from the Irish Social Sciences data archive. Data for the Millennium Cohort Study is also freely available from the UK data Service. Data for G21 and EPITeen can be obtained by contacting Henrique Barros and data for Cardiovascular Risk in Youngs Finns can be obtained from Olli Raitakari.
Collaborators The members of the LIFEPATH Consortium are (alphabetic order): Harri Alenius, Mauricio Avendano, HB, Murielle Bochud, Cristian Carmeli, Luca Carra, Raphaele Castagné, Marc Chadeau-Hyam, Françoise Clavel-Chapelon, Giuseppe Costa, Emilie Courtin, Cyrille Delpierre, Angelo D'Errico, Pierre-Antoine Dugué, Paul Elliott, SF, Valérie Gares, Graham Giles, Marcel Goldberg, Dario Greco, Allison Hodge, Michelle Kelly Irving, Piia Karisola, MK, Vittorio Krogh,Thierry Lang, RL,Benoit Lepage,Johan Mackenbach, Michael Marmot, CM, Roger Milne, Peter Muennig, Wilma Nusselder, Salvatore Panico, Dusan Petrovic, Silvia Polidoro, Martin Preisig, OR, AIR, Fulvio Ricceri, OR, Jose Rubio Valverde, Carlotta Sacerdote, Roberto Satolli, Gianluca Severi, Martin Shipley, Silvia Stringhini, Rosario Tumino, PV, Peter Vollenweider, and Marie Zins.