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Associations between birth registration and early child growth and development: evidence from 31 low- and middle-income countries.

ABSTRACT: BACKGROUND:Lack of legal identification documents can impose major challenges for children in low- and middle-income countries (LMICs). The aim of this study was to investigate the association between not having a birth certificate and young children's physical growth and developmental outcomes in LMICs. METHODS:We combined nationally representative data from the Multiple Indicator Cluster Surveys in 31 LMICs. For our measure of birth registration, primary caregivers reported on whether the child had a birth certificate. Early child outcome measures focused on height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ), weight-for-height z-scores (WHZ), and standardized scores of the Early Childhood Development Index (ECDI) for a subsample of children aged 36-59 months. We used linear regression models with country fixed effects to estimate the relationship between birth registration and child outcomes. In fully adjusted models, we controlled for a variety of child, caregiver, household, and access to child services covariates, including cluster-level fixed effects. RESULTS:In the total sample, 34.7% of children aged 0-59 months did not possess a birth certificate. After controlling for covariates, not owning a birth certificate was associated with lower HAZ (??=?-?0.18; 95% CI: -0.23, -?0.14), WAZ (??=?-?0.10, 95% CI: -0.13, -?0.07), and ECDI z-scores (??=?-?0.10; 95% CI: -0.13, -?0.07) among children aged 36-59 months. CONCLUSION:Our findings document links between birth registration and children's early growth and development outcomes. Efforts to increase birth registration may be promising for promoting early childhood development in LMICs.

SUBMITTER: Jeong J

PROVIDER: S-EPMC5977554 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Associations between birth registration and early child growth and development: evidence from 31 low- and middle-income countries.

Jeong Joshua J Bhatia Amiya A Fink Günther G

BMC public health 20180530 1

<h4>Background</h4>Lack of legal identification documents can impose major challenges for children in low- and middle-income countries (LMICs). The aim of this study was to investigate the association between not having a birth certificate and young children's physical growth and developmental outcomes in LMICs.<h4>Methods</h4>We combined nationally representative data from the Multiple Indicator Cluster Surveys in 31 LMICs. For our measure of birth registration, primary caregivers reported on w ...[more]

PMID: 29848302

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Project description:ImportanceWorldwide, preterm birth (PTB) is the single largest cause of deaths in the perinatal and neonatal period and is associated with increased morbidity in young children. The cause of PTB is multifactorial, and the development of generalizable biological models may enable early detection and guide therapeutic studies.ObjectiveTo investigate the ability of transcriptomics and proteomics profiling of plasma and metabolomics analysis of urine to identify early biological measurements associated with PTB.Design, setting, and participantsThis diagnostic/prognostic study analyzed plasma and urine samples collected from May 2014 to June 2017 from pregnant women in 5 biorepository cohorts in low- and middle-income countries (LMICs; ie, Matlab, Bangladesh; Lusaka, Zambia; Sylhet, Bangladesh; Karachi, Pakistan; and Pemba, Tanzania). These cohorts were established to study maternal and fetal outcomes and were supported by the Alliance for Maternal and Newborn Health Improvement and the Global Alliance to Prevent Prematurity and Stillbirth biorepositories. Data were analyzed from December 2018 to July 2019.ExposuresBlood and urine specimens that were collected early during pregnancy (median sampling time of 13.6 weeks of gestation, according to ultrasonography) were processed, stored, and shipped to the laboratories under uniform protocols. Plasma samples were assayed for targeted measurement of proteins and untargeted cell-free ribonucleic acid profiling; urine samples were assayed for metabolites.Main outcomes and measuresThe PTB phenotype was defined as the delivery of a live infant before completing 37 weeks of gestation.ResultsOf the 81 pregnant women included in this study, 39 had PTBs (48.1%) and 42 had term pregnancies (51.9%) (mean [SD] age of 24.8 [5.3] years). Univariate analysis demonstrated functional biological differences across the 5 cohorts. A cohort-adjusted machine learning algorithm was applied to each biological data set, and then a higher-level machine learning modeling combined the results into a final integrative model. The integrated model was more accurate, with an area under the receiver operating characteristic curve (AUROC) of 0.83 (95% CI, 0.72-0.91) compared with the models derived for each independent biological modality (transcriptomics AUROC, 0.73 [95% CI, 0.61-0.83]; metabolomics AUROC, 0.59 [95% CI, 0.47-0.72]; and proteomics AUROC, 0.75 [95% CI, 0.64-0.85]). Primary features associated with PTB included an inflammatory module as well as a metabolomic module measured in urine associated with the glutamine and glutamate metabolism and valine, leucine, and isoleucine biosynthesis pathways.Conclusions and relevanceThis study found that, in LMICs and high PTB settings, major biological adaptations during term pregnancy follow a generalizable model and the predictive accuracy for PTB was augmented by combining various omics data sets, suggesting that PTB is a condition that manifests within multiple biological systems. These data sets, with machine learning partnerships, may be a key step in developing valuable predictive tests and intervention candidates for preventing PTB.

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Associations between birth registration and early child growth and development: evidence from 31 low- and middle-income countries.

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Associations between birth registration and early child growth and development: evidence from 31 low- and middle-income countries.

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