BMJ Open (Oct 2019)
Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries
- Aluísio J D Barros,
- Günther Fink,
- Goodarz Danaei,
- Christopher R Sudfeld,
- Rose McGready,
- Nynke van den Broek,
- Joseph M Braun,
- Karim Manji,
- Shams E Arifeen,
- Melissa Gladstone,
- Jena Hamadani,
- Fahmida Tofail,
- Alicia Matijasevich,
- Sunita Taneja,
- Honorati Masanja,
- Wafaie Fawzi,
- Ayesha Sania,
- Dana C McCoy,
- Zhaozhong Zhu,
- Mary C Smith Fawzi,
- Mehmet Akman,
- David Bellinger,
- Maureen M Black,
- Alemtsehay Bogale,
- Verena Carrara,
- Paulita Duazo,
- Christopher Duggan,
- Lia C H Fernald,
- Alexis J Handal,
- Siobán Harlow,
- Melissa Hidrobo,
- Chris Kuzawa,
- Ingrid Kvestad,
- Lindsey Locks,
- Christine McDonald,
- Arjumand Rizvi,
- Darci Santos,
- Leticia Santos,
- Dilsad Save,
- Roger Shapiro,
- Barbara Stoecker,
- Martha-Maria Tellez-Rojo,
- Aisha K Yousafzai
Affiliations
- Aluísio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
- Günther Fink
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Goodarz Danaei
- associate professor
- Christopher R Sudfeld
- Department of Global Health and Population and Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
- Rose McGready
- 2 Centre for Tropical Disease and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Nynke van den Broek
- Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UK
- Joseph M Braun
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
- Karim Manji
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
- Shams E Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
- Melissa Gladstone
- Department of Women and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Jena Hamadani
- 12 Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
- Fahmida Tofail
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
- Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil
- Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
- Honorati Masanja
- Department of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Dar es Salaam, United Republic of Tanzania
- Wafaie Fawzi
- Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA
- Ayesha Sania
- Psychiatry, Columbia University Irving Medical Center, New York City, New York, USA
- Dana C McCoy
- Education Policy and Program Evaluation, Harvard Graduate School of Education, Cambridge, Massachusetts, USA
- Zhaozhong Zhu
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Mary C Smith Fawzi
- Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Mehmet Akman
- 8 Department of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey
- David Bellinger
- 11 Department of Neurology, Harvard Medical School and Boston Children’s Hospital, Boston, Massachusetts, USA
- Maureen M Black
- International Education, RTI International, Research Triangle Park, North Carolina, USA
- Alemtsehay Bogale
- 13 Nutrition and Scientific Affairs, The Nature’s Bounty Co, Ronkonkoma, New York, USA
- Verena Carrara
- 1Infectious Diseases Data Observatory (IDDO), University of Oxford, UK
- Paulita Duazo
- 17 Office of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines
- Christopher Duggan
- Center for Nutrition, Boston Children’s Hospital, Boston, Massachusetts, USA
- Lia C H Fernald
- 19 Community Health Sciences, School of Public Health, University of California, Berkeley, California, USA
- Alexis J Handal
- 21 College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA
- Siobán Harlow
- 1 Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Melissa Hidrobo
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA
- Chris Kuzawa
- 24 Department of Anthropology, Northwestern University, Evanston, Illinois, USA
- Ingrid Kvestad
- 5 Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway
- Lindsey Locks
- 26 Department of Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Christine McDonald
- 30 Children`s Hospital Oakland Research Institute, UCSF Benioff Children`s Hospital, Oakland, California, USA
- Arjumand Rizvi
- 1 Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
- Darci Santos
- 34 Department of Collective Health, Universidade Federal da Bahia, Salvador, Brazil
- Leticia Santos
- 34 Department of Collective Health, Universidade Federal da Bahia, Salvador, Brazil
- Dilsad Save
- 35 Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey
- Roger Shapiro
- Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana
- Barbara Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
- Martha-Maria Tellez-Rojo
- 40 Division of Research on Public Health, National Institute of Perinatology, Mexico City, Mexico
- Aisha K Yousafzai
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- DOI
- https://doi.org/10.1136/bmjopen-2018-026449
- Journal volume & issue
-
Vol. 9,
no. 10
Abstract
Objective To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).Design Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.Data sources 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.Eligibility criteria for selecting studies 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.Analyses 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.Results 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.Conclusions 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.
