Early childhood growth and cognitive outcomes: Findings from the MAL‐ED study |
| |
| Authors: | Rebecca J. Scharf Elizabeth T. Rogawski Laura E. Murray‐Kolb Angelina Maphula Erling Svensen Fahmida Tofail Muneera Rasheed Claudia Abreu Angel Orbe Vasquez Rita Shrestha Laura Pendergast Estomih Mduma Beena Koshy Mark R. Conaway James A. Platts‐Mills Richard L. Guerrant Mark D. DeBoer |
| |
| Affiliation: | 1. Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA;2. Center for Global Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA;3. Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA;4. Department of Nutrition Sciences, Penn State University, University Park, Pennsylvania, USA;5. Department of Psychology, University of Venda, Thohoyandou, South Africa;6. Department of Global Health and Primary Care, University of Bergen, Bergen, Norway;7. Center for Nutrition and Food Security, icddr‐b, Dhaka, Bangladesh;8. Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan;9. Department of Microbiology, Federal University of Ceará, Fortaleza, Brazil;10. Department of Psychology, PRISMA, Iquitos, Peru;11. Department of Psychology, Siddhi Memorial Hospital, Bhaktapur, Nepal;12. Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA;13. Haydom Global Health Research Centre, Haydom, Tanzania;14. Department of Developmental Pediatrics, Christian Medical College, Vellore, India |
| |
| Abstract: | Although many studies around the world hope to measure or improve developmental progress in children to promote community flourishing and productivity, growth is sometimes used as a surrogate because cognitive skills are more difficult to measure. Our objective was to assess how childhood measures of anthropometry correlate with measures of child development in low‐income settings with high prevalence of poor nutrition and enteric disease, to inform studies considering growth outcomes in the absence of direct child developmental skill assessment. Children from the MAL‐ED study were followed from birth to 24 months of age in field sites in 8 low‐ and middle‐income countries across 3 continents. Monthly weight, length, and head circumference measurements were performed. At 24 months, the Bayley Scales of Infant and Toddler Development was administered. We correlated cognitive measures at 24 months with anthropometric measurements from birth to 2 years comparing 3 constructs: absolute attained monthly measures, summative difference in measures from the mean growth curve, and rate of change in measures. Growth faltering at multiple time periods is related to Bayley cognitive outcomes at 24 months. Birthweight, overall growth by 18–24 months, and rate of growth in the 6‐ to 18‐month period were most associated with 24‐month developmental scores. In this study, head circumference measurements, compared with length, was more closely linked to cognitive scores at 24 months. Notably, all studies between growth and cognitive outcomes exhibited low r2 values (0.001–0.049). Anthropometric measures, particularly head circumference, were related to cognitive development, although explaining a low percent of variance. When feasible, direct measures of child development may be more useful. |
| |
| Keywords: | early childhood development stunting malnutrition growth global health cognition |
|
|
