Dataset Information

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

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Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.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 We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.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.

SUBMITTER: Sania A

PROVIDER: S-EPMC6797384 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

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

BMJ open 20191003 10

<h4>Objective</h4>To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).<h4>Design</h4>Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.<h4>Data sources</h4>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 ...[more]

PMID: 31585969

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Project description:BackgroundBabies with low birthweight (<2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associated with these two characteristics in low-income and middle-income countries.MethodsFor this pooled analysis, we searched all available studies and identified 20 cohorts (providing data for 2,015,019 livebirths) from Asia, Africa, and Latin America that recorded data for birthweight, gestational age, and vital statistics through 28 days of life. Study dates ranged from 1982 through to 2010. We calculated relative risks (RR) and risk differences (RD) for mortality associated with preterm birth (<32 weeks, 32 weeks to <34 weeks, 34 weeks to <37 weeks), small-for-gestational-age (SGA; babies with birthweight in the lowest third percentile and between the third and tenth percentile of a US reference population), and preterm and SGA combinations.FindingsPooled overall RRs for preterm were 6·82 (95% CI 3·56-13·07) for neonatal mortality and 2·50 (1·48-4·22) for post-neonatal mortality. Pooled RRs for babies who were SGA (with birthweight in the lowest tenth percentile of the reference population) were 1·83 (95% CI 1·34-2·50) for neonatal mortality and 1·90 (1·32-2·73) for post-neonatal mortality. The neonatal mortality risk of babies who were both preterm and SGA was higher than that of babies with either characteristic alone (15·42; 9·11-26·12).InterpretationMany babies in low-income and middle-income countries are SGA. Preterm birth affects a smaller number of neonates than does SGA, but is associated with a higher mortality risk. The mortality risks associated with both characteristics extend beyond the neonatal period. Differentiation of the burden and risk of babies born preterm and SGA rather than with low birthweight could guide prevention and management strategies to speed progress towards Millennium Development Goal 4--the reduction of child mortality.FundingBill & Melinda Gates Foundation.

Dataset Information

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

Objective

Design

Data sources

Eligibility criteria for selecting studies

Analyses

Results

Conclusions

Publications

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

Similar Datasets

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