Ayesha SaniaChristopher R. SudfeldGoodarz DanaeiGünther FinkDana C. McCoyZhaozhong ZhuMary C.Smith FawziMehmet AkmanShams E. ArifeenAluisio J.D. BarrosDavid BellingerMaureen M. BlackAlemtsehay BogaleJoseph M. BraunNynke Van Den BroekVerena CarraraPaulita DuazoChristopher DugganLia C.H. FernaldMelissa GladstoneJena HamadaniAlexis J. HandalSiobán HarlowMelissa HidroboChris KuzawaIngrid KvestadLindsey LocksKarim ManjiHonorati MasanjaAlicia MatijasevichChristine McDonaldRose McGreadyArjumand RizviDarci SantosLeticia SantosDilsad SaveRoger ShapiroBarbara StoeckerTor A. StrandSunita TanejaMartha Maria Tellez-RojoFahmida TofailAisha K. YousafzaiMajid EzzatiWafaie FawziNORCE Norwegian Research Centre ASIfakara Health InstituteUniversity of Dar Es SalaamUniversity of San CarlosThe Aga Khan University HospitalSociety for Applied Studies KolkataInstituto Nacional de PerinatologiaShoklo Malaria Research UnitUniversity of New MexicoHarvard T.H. Chan School of Public HealthChildren's Hospital BostonHarvard Graduate School of EducationColumbia University Irving Medical CenterUniversity of California, BerkeleyLiverpool School of Tropical MedicineUniversity of LiverpoolUniversity of Michigan School of Public HealthImperial College LondonUniversity of Maryland, BaltimoreUniversidade Federal de PelotasUniversidade Federal da BahiaMahidol UniversityBrown UniversityInternational Centre for Diarrhoeal Disease Research BangladeshNuffield Department of Clinical MedicineUniversidade de Sao Paulo - USPNorthwestern UniversityOklahoma State University - StillwaterMarmara Üniversitesi Tip FakültesiChildren's Hospital Oakland Research InstituteHarvard Medical SchoolInternational Food Policy Research InstituteNature's Bounty Co.SCHWEIZERISCHES TROPEN- UND PUBLIC HEALTH-INSTITUT2020-01-272020-01-272019-10-01BMJ Open. Vol.9, No.10 (2019)204460552-s2.0-85072932180https://repository.li.mahidol.ac.th/handle/20.500.14594/51408© 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 Design Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.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.Mahidol UniversityMedicineArticleSCOPUS10.1136/bmjopen-2018-026449