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Prenatal nutrition, stimulation, and exposure to punishment are associated with early child motor, cognitive, language, and socioemotional development in Dar es Salaam, Tanzania
Author(s) -
Pitchik Helen O.,
Fawzi Wafaie W.,
McCoy Dana Charles,
Darling Anne Marie,
Abioye Ajibola I.,
Tesha Florence,
Smith Emily R.,
Mugusi Ferdinand,
Sudfeld Christopher R.
Publication year - 2018
Publication title -
child: care, health and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 82
eISSN - 1365-2214
pISSN - 0305-1862
DOI - 10.1111/cch.12605
Subject(s) - socioemotional selectivity theory , randomized controlled trial , child development , language development , medicine , cognitive development , pediatrics , motor skill , cognition , psychology , developmental psychology , psychiatry
Abstract Background Despite growing evidence that early life experiences and exposures can impact child development, there is limited research on how prenatal and early life nutrition and early life parenting practices predict specific domains of child development in resource‐limited settings. This study examines the association between prenatal factors, birth outcomes, and early life characteristics with motor, cognitive/language, and socioemotional development in Tanzania. Methods We assessed motor, cognitive/language, and socioemotional development among a cohort of 198 children aged 20–39 months in Dar es Salaam, Tanzania, whose mothers were previously enrolled in a randomized, placebo‐controlled trial of prenatal vitamin A and zinc supplementation. Linear regression models were used to assess standardized mean differences in child development scores for randomized prenatal regimen and pregnancy, delivery, and early childhood factors. Results Children born to mothers randomized to prenatal vitamin A had significantly lower reported motor scores in minimally adjusted and multivariate analyses, −0.29 SD , 95% CI [−0.54, −0.04], p = 0.03, as compared with children whose mothers did not receive vitamin A. There was no significant effect of randomized prenatal zinc on any development domain. Greater caregiver–child stimulation was associated with 0.38 SD , 95% CI [0.14, 0.63], p < 0.01, better cognitive/language scores, whereas children who experienced both verbal and physical punishment had 0.29 SD , 95% CI [−0.52, −0.05], p = 0.02, lower scores in socioemotional development. Maternal completion of primary school was associated with higher reported motor and cognitive/language development. Further, children of mothers who were <155 cm tall had lower cognitive and language scores. Conclusion Prenatal vitamin A supplements in a setting with low levels of vitamin A deficiency may not provide child development benefits. However, integrated environmental, educational, parenting, and stimulation interventions may have large positive effects across child development domains in resource‐limited settings.