Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries
Author:
Sania Ayesha, Sudfeld Christopher R, Danaei Goodarz, Fink Günther, McCoy Dana C, Zhu Zhaozhong, Fawzi Mary C Smith, Akman Mehmet, Arifeen Shams E, Barros Aluisio J D, Bellinger David, Black Maureen M, Bogale Alemtsehay, Braun Joseph M, van den Broek Nynke, Carrara Verena, Duazo Paulita, Duggan Christopher, Fernald Lia C H, Gladstone Melissa, Hamadani Jena, Handal Alexis J, Harlow Siobán, Hidrobo Melissa, Kuzawa Chris, Kvestad Ingrid, Locks Lindsey, Manji Karim, Masanja Honorati, Matijasevich Alicia, McDonald Christine, McGready Rose, Rizvi Arjumand, Santos Darci, Santos Leticia, Save Dilsad, Shapiro Roger, Stoecker Barbara, Strand Tor AORCID, Taneja Sunita, Tellez-Rojo Martha-Maria, Tofail Fahmida, Yousafzai Aisha K, Ezzati Majid, Fawzi Wafaie
Abstract
ObjectiveTo determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).DesignMeta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.Data sourcesWe searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on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 We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.Eligibility criteria for selecting studiesStudies that assessed at least one domain of child development in at least 100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.AnalysesLinear 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.ResultsWe 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.ConclusionsDifferential 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.
Funder
National Institute of Allergy and Infectious Diseases Grand Challenges Canada
Reference82 articles.
1. Early childhood development coming of age: science through the life course 2. Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level;Lu;Lancet Glob Health,2016 3. McCoy DC , Peet ED , Ezzati M , et al . Early childhood developmental status in low- and middle-income countries: national, regional, and global prevalence estimates using predictive modeling. PLoS Med 2016;13:e1002034.doi:10.1371/journal.pmed.1002034 4. Sensitive Periods in the Development of the Brain and Behavior 5. Neuroscience, Molecular Biology, and the Childhood Roots of Health Disparities
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