Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries.

Journal: BMJ open

Volume: 9

Issue: 10

Year of Publication: 2020

Affiliated Institutions:  ICAP and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York city, New York, USA ays@mail.harvard.edu. Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA. Deaprtment of Global Health and Population, and Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA. Household Economics and Health System Research Unit, Schweizerisches Tropen- und Public Health-Institut, Basel, Switzerland. Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts, USA. Departments of Epidemiology and Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA. Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA. Department of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey. Maternal and Child Health Division, ICDDR,B, Dhaka, Bangladesh. Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. Department of Neurology, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA. Nutrition and Scientific Affairs, The Nature's Bounty Co, Ronkonkoma, New York, USA. Brown University School of Public Health, Providence, Rhode Island, USA. Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UK. Department of Maternal and Child Health, Shoklo Malaria Research Unit, Mae Sot, Thailand. Office of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines. Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA. Community Health Sciences, School of Public Health, University of California, Berkeley, California, USA. Women and Children's Health, University of Liverpool, Institute of Translational Medicine, Liverpool, UK. College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA. Poverty Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA. Department of Anthropology, Northwestern University, Evanston, Illinois, USA. Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway. Department of Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA. Department of Pediatrics and Child Health, Muhibili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Ifakara Health Institute, Dar es Salam, Tanzania. Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brasil. Children's Hospital Oakland Research Institute, UCSF Benioff Children's Hospital, Oakland, California, USA. Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mae Sot, Thailand. Pediatrics and Child Health, Aga Khan Medical University, Karachi, Pakistan. Department of Collective Health, Universidade Federal da Bahia, Salvador, Brazil. Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey. Department of Immunology and Infectious Disease, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA. Department of Nutritional Sciences, Oklahoma State University College of Human Environmental Sciences, Stillwater, Oklahoma, USA. Department of Laboratory Medicine, Sykehuset Innlandet Helseforetaket, Brumunddal, Norway. Centre for Health Research and Development, Society for Applied Studies, New Delhi, India. Division of Research on Public Health, National Institute of Perinatology, Mexico City, Mexico. Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh. MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. Deaprtment of Global Health and Population, Epidemiology, and Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.

Abstract summary 

To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study.Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses.We retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs.Differential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.

Authors & Co-authors:  Sania Ayesha A Sudfeld Christopher R CR Danaei Goodarz G Fink Günther G McCoy Dana C DC Zhu Zhaozhong Z Fawzi Mary C Smith MCS Akman Mehmet M Arifeen Shams E SE Barros Aluisio J D AJD Bellinger David D Black Maureen M MM Bogale Alemtsehay A Braun Joseph M JM van den Broek Nynke N Carrara Verena V Duazo Paulita P Duggan Christopher C Fernald Lia C H LCH Gladstone Melissa M Hamadani Jena J Handal Alexis J AJ Harlow Siobán S Hidrobo Melissa M Kuzawa Chris C Kvestad Ingrid I Locks Lindsey L Manji Karim K Masanja Honorati H Matijasevich Alicia A McDonald Christine C McGready Rose R Rizvi Arjumand A Santos Darci D Santos Leticia L Save Dilsad D Shapiro Roger R Stoecker Barbara B Strand Tor A TA Taneja Sunita S Tellez-Rojo Martha-Maria MM Tofail Fahmida F Yousafzai Aisha K AK Ezzati Majid M Fawzi Wafaie W

Study Outcome 

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Statistics
Citations :  Black MM, Walker SP, Fernald LCH, et al. . Early childhood development coming of age: science through the life course. Lancet 2017;389:77–90. 10.1016/S0140-6736(16)31389-7
Authors :  45
Identifiers
Doi : e026449
SSN : 2044-6055
Study Population
Mothers
Mesh Terms
Child
Other Terms
SGA;access to clean water;access to sanitation;breast feeding;cognitive development;diarrhoea;early life risk factors;language development;maternal anaemia and anaemia in infancy;maternal education;maternal short stature;motor development;paternal education;preterm
Study Design
Study Approach
Country of Study
Publication Country
England