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Title: Early life risk factors of motor, cognitive and language development: A pooled analysis of studies from low/middle-income countries
Authors: Ayesha Sania
Christopher R. Sudfeld
Goodarz Danaei
Günther Fink
Dana C. McCoy
Zhaozhong Zhu
Mary C.Smith Fawzi
Mehmet Akman
Shams E. Arifeen
Aluisio J.D. Barros
David Bellinger
Maureen M. Black
Alemtsehay Bogale
Joseph M. Braun
Nynke Van Den Broek
Verena Carrara
Paulita Duazo
Christopher Duggan
Lia C.H. Fernald
Melissa Gladstone
Jena Hamadani
Alexis J. Handal
Siobán Harlow
Melissa Hidrobo
Chris Kuzawa
Ingrid Kvestad
Lindsey Locks
Karim Manji
Honorati Masanja
Alicia Matijasevich
Christine McDonald
Rose McGready
Arjumand Rizvi
Darci Santos
Leticia Santos
Dilsad Save
Roger Shapiro
Barbara Stoecker
Tor A. Strand
Sunita Taneja
Martha Maria Tellez-Rojo
Fahmida Tofail
Aisha K. Yousafzai
Majid Ezzati
Wafaie Fawzi
NORCE Norwegian Research Centre AS
Ifakara Health Institute
University of Dar Es Salaam
University of San Carlos
The Aga Khan University Hospital
Society for Applied Studies Kolkata
Instituto Nacional de Perinatologia
Shoklo Malaria Research Unit
University of New Mexico
Harvard T.H. Chan School of Public Health
Children's Hospital Boston
Harvard Graduate School of Education
Columbia University Irving Medical Center
University of California, Berkeley
Liverpool School of Tropical Medicine
University of Liverpool
University of Michigan School of Public Health
Imperial College London
University of Maryland, Baltimore
Universidade Federal de Pelotas
Universidade Federal da Bahia
Mahidol University
Brown University
International Centre for Diarrhoeal Disease Research Bangladesh
Nuffield Department of Clinical Medicine
Universidade de Sao Paulo - USP
Northwestern University
Oklahoma State University - Stillwater
Marmara Üniversitesi Tip Fakültesi
Children's Hospital Oakland Research Institute
Harvard Medical School
International Food Policy Research Institute
Nature's Bounty Co.
Keywords: Medicine
Issue Date: 1-Oct-2019
Citation: BMJ Open. Vol.9, No.10 (2019)
Abstract: © 2019 Author(s). 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 Design Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.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.
ISSN: 20446055
Appears in Collections:Scopus 2019

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