Concordance of weight status between mothers and children: A secondary analysis of the Pakistan Demographic and Health Survey VII

Familial concordance of nutritional status is an emerging field of study that may guide the development of interventions that operate beyond the individual and within the family context. Little published data exist for concordance of nutritional status within Pakistani households. We assessed the associations between weight status of mothers and their children in a nationally representative sample of households in Pakistan using Demographic and Health Survey data. Our analysis included 3465 mother-child dyads, restricting to children under-five years of age with body mass index (BMI) information on their mothers.  We used linear regression models to assess the associations between maternal BMI category (underweight, normal weight, overweight, obese) and child’s weight-for-height z-score (WHZ), accounting for socio-demographic characteristics of mothers and children. We assessed these relationships in all children under-five and also stratified by age of children (younger than 2 years and 2 to 5 years). In all children under-five and in children 2 to 5 years, maternal BMI was positively associated with child’s WHZ, while there was no association between maternal BMI and child WHZ for children under-two. The findings indicate that the weight status of mother’s is positively associated with that of their children.  These associations have implications for interventions aimed at healthy weights of families. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No grants or other funding sources were provided for the analysis and writing of this manuscript. Regarding survey design and data collection, financial support was provided by the United States Agency for International Development. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was reviewed and approved by the National Bioethics Committee of the Pakistan Health Research Council and the Inner City Fund/ ICF Institutional Review Board. Prior to obtaining access to and performing analysis on the PDHS-7 data, the authors of the present study submitted a concept note, gained data access, and obtained permission from USAID. The data were de-identified and anonymized by the DHS program prior to being shared, therefore not considered human subjects research by an author-affiliated institution (Emory University, Atlanta, GA, USA) and not requiring further ethical clearance. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The PDHS dataset is available at: https://dhsprogram.com/. Prior to obtaining access to and performing analysis on the PDHS-7 data, a concept note may be required, as was the case for the authors of the manuscript. The code used for data restructuring and analysis is available at: doi:10.5281/zenodo.7794384