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BMJ 2009; 338 doi: (Published 28 April 2009) Cite this as: BMJ 2009;338:b1712

Maternal height linked to child mortality in India

A national survey of Indian children has found a clear link between mortality in under 5s and maternal height. The absolute risk of death for children with mothers measuring at least 160 cm was 0.05 (95% CI 0.04 to 0.07) compared with 0.09 (0.07 to 0.12) for children born to mothers measuring less than 145 cm, a significant increase of 70% (relative risk 1.71, 1.37 to 2.14).

The authors also found a significant association between shorter stature in women and stunting, wasting, and underweight in their children. All three indicators of poor health were common. Nearly a half (17 428/40 089) of surviving children were stunted, 42.2% (14 791) were underweight, and nearly a fifth (7236) had wasting. The survey was nationally representative, and included between 40 000 and 50 000 children under 5 from all 29 states in India. The analysis was fully adjusted for demographic and social factors that influence childhood mortality.

The relative risks associated with each 1 cm decrease in maternal height were small but discernible, and the large numbers allowed the authors to calculate risks with some precision. They are fairly certain the link is real, and it shows how poor health in childhood, which determines growth, is passed from generation to generation.

US citizens are overwhelmed by the wrong kind of drug information

American citizens are inundated with $5bn (£3.4bn; €3.8bn) of direct to consumer advertising each year. Most of it is top heavy with spin and light on essential facts, such as the risks and benefits of treatment. Summary information is required by law, but at least two experts describe it as a “user hostile welter of tiny print” that is verbose, dull, confusing, and inadequate.

Many US health professionals would like to see direct to consumer advertising banned, just as it is in virtually all other industrialised nations. Failing that, the new administration should introduce reforms …

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