Growth in early life and physical and intellectual development at school age: a cohort study

Stunting among children under two years in Indonesia: Does maternal education matter?

BACKGROUND

Measuring height for age is one of the essential indicators for evaluating children's growth. The study analyzes the association between maternal education and stunting among children under two years in Indonesia.

METHODS

The study employed secondary data from the 2017 Indonesia Nutritional Status Monitoring Survey. The unit of analysis was children under two years, and the study obtained weighted samples of 70,293 children. Besides maternal education, other independent variables analyzed in this study were residence, maternal age, maternal marital status, maternal employment, children's age, and gender. In the final stage, the study occupied a multivariate test by binary logistic regression test.

RESULTS

The results show the proportion of stunted children under two years in Indonesia nationally is 20.1%. Mothers in primary school and under education categories are 1.587 times more likely than mothers with a college education to have stunted children under two years (95% CI 1.576-1.598). Meanwhile, mothers with a junior high school education have a chance of 1.430 times more than mothers with a college education to have stunted children under two years (95% CI 1.420-1.440). Moreover, mothers with education in the senior high school category have 1.230 times more chances than mothers with a college education to have stunted children under two years (95% CI 1.222-1.238).

CONCLUSION

The study concluded that the maternal education level was associated with stunting children under two years in Indonesia. The lower the mother's level of education, the higher the chances of a mother having stunted children under two years.

Child Linear Growth During and After the First 1000 Days Is Positively Associated with Intellectual Functioning and Mental Health in School-Age Children in Vietnam

BACKGROUND

Millions of children fail to meet their developmental potential and experience mental health concerns globally. Evidence is mixed on whether growth beyond the first 1000 d of life influences intellectual functioning and mental health in school-age children.

OBJECTIVES

We examined associations of childhood growth before and after the first 1000 d of life with child intellectual functioning and mental health at age 6-7 y.

METHODS

We used data from a follow-up of a randomized controlled trial of preconception supplementation (PRECONCEPT study) in Vietnam. A total of 5011 women participated in the study and 1579 children were born during 2012-2014. At age 6-7 y, child intellectual functioning was assessed using the Wechsler Intelligence Scale for Children, and mental health concerns were measured using the Strengths and Difficulties Questionnaire. Multivariable linear models were used to examine the independent association of child size at age 2 y [height-for-age z-score (HAZ) and body-mass-index z-score (BMIZ)] and conditional measures of linear and ponderal growth between the ages of 2 and 7 y.

RESULTS

HAZ at 2 y was positively associated with the Full-Scale Intelligence Quotient (β = 1.4; 95% CI: 0.5, 2.2 points) and its subdomains, namely Perceptual Reasoning Index, Working Memory Index, and Processing Speed Index (β = 1.0-1.4 points). Higher HAZ at 2 y was associated with lower overall mental health concerns (β = -0.24; 95% CI: -0.47, -0.01) and peer problems (β = -0.08; 95% CI: -0.17, -0.01). Faster height gain between 2 and 7 y was associated with higher total intellectual functioning (β = 0.9; 95% CI: 0.02, 1.8) and fewer emotional issues (β = -0.09; 95% CI: -0.18, -0.01). BMIZ at 2 y was not associated with intellectual functioning but was marginally associated with higher conduct and peer problems. Conditional weight gain between 2 and 7 y was not associated with child intellectual functioning or mental health in young school-age children.

CONCLUSIONS

Child linear growth both during and beyond the first 1000 d is positively associated with intellectual functioning and mental health during the early school-age years.

Patterns of Growth in Childhood in Relation to Adult Schooling Attainment and Intelligence Quotient in 6 Birth Cohorts in Low- and Middle-Income Countries: Evidence from the Consortium of Health-Oriented Research in Transitioning Societies (COHORTS)

BACKGROUND

Growth faltering has been associated with poor intellectual performance. The relative strengths of associations between growth in early and in later childhood remain underexplored.

OBJECTIVES

We examined the association between growth in childhood and adult human capital in 5 low- and middle-income countries (LMICs).

METHODS

We analyzed data from 9503 participants in 6 prospective birth cohorts from 5 LMICs (Brazil, Guatemala, India, the Philippines, and South Africa). We used linear and quasi-Poisson regression models to assess the associations between measures of height and relative weight at 4 age intervals [birth, age ∼2 y, midchildhood (MC), adulthood] and 2 dimensions of adult human capital [schooling attainment and Intelligence Quotient (IQ)].

RESULTS

Meta-analysis of site- and sex-specific estimates showed statistically significant associations between size at birth and height at ∼2 y and the 2 outcomes (P < 0.001). Weight and length at birth and linear growth from birth to ∼2 y of age (1 z-score difference) were positively associated with schooling attainment (β: 0.13; 95% CI: 0.08, 0.19, β: 0.17; 95% CI: 0.07, 0.32, and β: 0.25, 95% CI: 0.10, 0.40, respectively) and adult IQ (β: 0.74, 95% CI: 0.35, 1.14, β: 0.73, 95% CI: 0.35, 1.10, and β: 1.52, 95% CI: 0.96, 2.08, respectively). Linear growth from age 2 y to MC and from MC to adulthood was not associated with higher school attainment or IQ. Change in relative weight in early childhood, MC, and adulthood was not associated with either outcome.

CONCLUSIONS

Linear growth in the first 1000 d is a predictor of schooling attainment and IQ in adulthood in LMICs. Linear growth in later periods was not associated with either of these outcomes. Changes in relative weight across the life course were not associated with schooling and IQ in adulthood.