Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study.
BACKGROUND:Globally more than 150 million children under age 5 years were stunted in 2018, primarily in low- and middle-income countries (LMICs), and the impact of early-onset, persistent stunting has not been well explored. To explore the association between early-onset persistent stunting in child...
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doaj-bfb1a700695e41b985fb1574e3d545ae2021-03-03T21:25:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01151e022783910.1371/journal.pone.0227839Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study.Md Ashraful AlamStephanie A RichardShah Mohammad FahimMustafa MahfuzBaitun NaharSubhasish DasBinod ShresthaBeena KoshyEstomih MdumaJessica C SeidmanLaura E Murray-KolbLaura E CaulfieldTahmeed AhmedBACKGROUND:Globally more than 150 million children under age 5 years were stunted in 2018, primarily in low- and middle-income countries (LMICs), and the impact of early-onset, persistent stunting has not been well explored. To explore the association between early-onset persistent stunting in children and cognitive development at 5 years of age, and to identify the factors associated with early-onset stunting. METHODS AND FINDINGS:Children from the MAL-ED cohort study were followed from birth to 5 years of age in six LMICs. The Wechsler Preschool Primary Scales of Intelligence (WPPSI) was used to assess cognitive abilities (fluid reasoning) at 5 years and was adapted for each culture. Stunting was categorized as early-onset persistent (first stunted at 1-6 months and persisting at 60 months), early-onset recovered (first stunted at 1-6 months and not stunted at 60 months), late-onset persistent (first stunted at 7-24 months and persisting at 60 months), late-onset recovered (first stunted at 7-24 months and not stunted at 60 months), and never (never stunted). Mixed effects linear models were used to estimate the relationship between stunting status and cognitive development. Children with early-onset persistent stunting had significantly lower cognitive scores (-2.10 (95% CI: -3.85, -0.35)) compared with those who were never stunted. Transferrin receptor (TfR) was also negatively associated with cognitive development (-0.31 (95% CI: -0.49, -0.13)), while the HOME inventory, an index of quality of the home environment (0.46 (95% CI: 0.21, 0.72)) and socio-economic status (1.50 (95% CI: 1.03, 1.98)) were positively associated with cognitive development. CONCLUSIONS:Early-onset persistent stunting was associated with lower cognitive development in children at 5 years of age in this cohort of children.https://doi.org/10.1371/journal.pone.0227839 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Md Ashraful Alam Stephanie A Richard Shah Mohammad Fahim Mustafa Mahfuz Baitun Nahar Subhasish Das Binod Shrestha Beena Koshy Estomih Mduma Jessica C Seidman Laura E Murray-Kolb Laura E Caulfield Tahmeed Ahmed |
spellingShingle |
Md Ashraful Alam Stephanie A Richard Shah Mohammad Fahim Mustafa Mahfuz Baitun Nahar Subhasish Das Binod Shrestha Beena Koshy Estomih Mduma Jessica C Seidman Laura E Murray-Kolb Laura E Caulfield Tahmeed Ahmed Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. PLoS ONE |
author_facet |
Md Ashraful Alam Stephanie A Richard Shah Mohammad Fahim Mustafa Mahfuz Baitun Nahar Subhasish Das Binod Shrestha Beena Koshy Estomih Mduma Jessica C Seidman Laura E Murray-Kolb Laura E Caulfield Tahmeed Ahmed |
author_sort |
Md Ashraful Alam |
title |
Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. |
title_short |
Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. |
title_full |
Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. |
title_fullStr |
Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. |
title_full_unstemmed |
Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. |
title_sort |
impact of early-onset persistent stunting on cognitive development at 5 years of age: results from a multi-country cohort study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2020-01-01 |
description |
BACKGROUND:Globally more than 150 million children under age 5 years were stunted in 2018, primarily in low- and middle-income countries (LMICs), and the impact of early-onset, persistent stunting has not been well explored. To explore the association between early-onset persistent stunting in children and cognitive development at 5 years of age, and to identify the factors associated with early-onset stunting. METHODS AND FINDINGS:Children from the MAL-ED cohort study were followed from birth to 5 years of age in six LMICs. The Wechsler Preschool Primary Scales of Intelligence (WPPSI) was used to assess cognitive abilities (fluid reasoning) at 5 years and was adapted for each culture. Stunting was categorized as early-onset persistent (first stunted at 1-6 months and persisting at 60 months), early-onset recovered (first stunted at 1-6 months and not stunted at 60 months), late-onset persistent (first stunted at 7-24 months and persisting at 60 months), late-onset recovered (first stunted at 7-24 months and not stunted at 60 months), and never (never stunted). Mixed effects linear models were used to estimate the relationship between stunting status and cognitive development. Children with early-onset persistent stunting had significantly lower cognitive scores (-2.10 (95% CI: -3.85, -0.35)) compared with those who were never stunted. Transferrin receptor (TfR) was also negatively associated with cognitive development (-0.31 (95% CI: -0.49, -0.13)), while the HOME inventory, an index of quality of the home environment (0.46 (95% CI: 0.21, 0.72)) and socio-economic status (1.50 (95% CI: 1.03, 1.98)) were positively associated with cognitive development. CONCLUSIONS:Early-onset persistent stunting was associated with lower cognitive development in children at 5 years of age in this cohort of children. |
url |
https://doi.org/10.1371/journal.pone.0227839 |
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