Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries - PubMed (original) (raw)

Review

. 2019 Oct 3;9(10):e026449.

doi: 10.1136/bmjopen-2018-026449.

Christopher R Sudfeld 2, Goodarz Danaei 3, Günther Fink 4, Dana C McCoy 5, Zhaozhong Zhu 6, Mary C Smith Fawzi 7, Mehmet Akman 8, Shams E Arifeen 9, Aluisio J D Barros 10, David Bellinger 11, Maureen M Black 12, Alemtsehay Bogale 13, Joseph M Braun 14, Nynke van den Broek 15, Verena Carrara 16, Paulita Duazo 17, Christopher Duggan 18, Lia C H Fernald 19, Melissa Gladstone 20, Jena Hamadani 9, Alexis J Handal 21, Siobán Harlow 22, Melissa Hidrobo 23, Chris Kuzawa 24, Ingrid Kvestad 25, Lindsey Locks 26, Karim Manji 27, Honorati Masanja 28, Alicia Matijasevich 29, Christine McDonald 30, Rose McGready 31 32, Arjumand Rizvi 33, Darci Santos 34, Leticia Santos 34, Dilsad Save 35, Roger Shapiro 36, Barbara Stoecker 37, Tor A Strand 38, Sunita Taneja 39, Martha-Maria Tellez-Rojo 40, Fahmida Tofail 41, Aisha K Yousafzai 2, Majid Ezzati 42, Wafaie Fawzi 43

Affiliations

Review

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

Ayesha Sania et al. BMJ Open. 2019.

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Design: Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.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 We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.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

Keywords: 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.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1

Figure 1

Flowchart of study selection.

Figure 2

Figure 2

Pooled estimates of association between maternal factors and development.BMI, body mass index.

Figure 3

Figure 3

Pooled estimates of association between child factors and development.

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