“If children living at altitude are, on average, more stunted than their peers at sea level, then a more significant effort to address high altitude stunting is needed.”Co-Author Kalle Hirvonen

CBS 4 reports according to new worldwide research published Monday, children born at 5,000 feet or more above sea level are typically smaller at birth and more likely to remain stunted than those born at lower altitudes. This was true even if the children were born into “ideal-home environments” defined as having good health coverage, higher living conditions and highly educated mothers, meaning stunting was unlikely to be due to common risk factors such as poor diet and disease. Growth declined as altitude grew.  Children living in ideal home environments grew at rates deemed standard by the WHO until they lived at around 1,650 feet above sea level. At that altitude and higher, children’s height-for-age scores began to decrease.

At levels approximately 5,000 feet above sea level, children were “born at shorter length and remained on a lower growth trajectory” than children who lived in cities at lower sea levels, according to the study published by JAMA Pediatrics. Prior research has shown growing shorter and slower at higher altitudes can lead to an increased risk of cognitive deficits and metabolic developmental impairments tied to chronic diseases in later life. The worldwide study looked at height-for-age data for more than 950,000 children in 59 countries.

“Pregnancies at high-altitudes are characterized by chronic hypoxia, or an inadequate supply of oxygen, which is consistently associated with a higher risk of fetal growth restriction.” 

It was thought that genetic adaption to residing at high altitude over multiple generations might mitigate the stunting, but the study did not show that:

“After birth, the growth curve for children in areas 1,500 (meters) or more above sea level was consistently lower, implying limited catch-up to growth levels of children residing in areas lower than 1,500 (meters) above sea level” 

The results should educate health professionals to more closely work with pregnant women to control the effects of high altitude on the fetus:

“A first step is to unravel the complex relationship linking altitude, hypoxia and fetal growth to identify effective interventions.” Co-Suthor Kaleab Baye

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