Open AccessThe association of early linear growth and haemoglobin concentration with later cognitive, motor, and social–emotional development at preschool age in Ghana
Author(s) -
Ocansey Maku E.,
AduAfarwuah Seth,
Kumordzie Sika M.,
Okronipa Harriet,
Young Rebecca R.,
Tamakloe Solace M.,
Oaks Brietta M.,
Arimond Mary,
Dewey Kathryn G.,
Prado Elizabeth L.
Publication year - 2019
Publication title -
maternal and child nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 63
eISSN - 1740-8709
pISSN - 1740-8695
DOI - 10.1111/mcn.12834
Subject(s) - medicine , pediatrics , cohort , population , linear growth , cognition , child development , demography , prospective cohort study , cohort study , motor skill , psychiatry , environmental health , mathematics , sociology
It is important to identify the periods during childhood when exposure to environmental risk factors results in long‐term neurodevelopmental deficits. Stunting and anaemia may be sensitive indicators of exposure to such risks. In a prospective cohort enrolled before birth, we investigated the association of developmental scores at 4–6 years with (a) birth length and linear growth during three postnatal periods and (2) haemoglobin (Hb) concentration at three time points. Children were participants in a follow‐up study of a randomized controlled trial of nutritional supplementation in Ghana. At 4–6 years, cognitive, motor, and social–emotional developments were assessed using standard tests adapted for this population. We estimated the associations of length‐for‐age z ‐score (LAZ) at birth and postnatal linear growth ( n = 710) and Hb ( n = 617) with developmental scores in regression models, using multistage least squares analysis to calculate uncorrelated residuals for postnatal growth. Cognitive development at 4–6 years was significantly associated with LAZ at birth (β = 0.12, 95% CI = 0.05, 0.19), ΔLAZ from 6 to 18 months (β = 0.16, 95% CI = 0.04, 0.28), and Hb at 18 months (β = 0.13, 95% CI = 0.06, 0.20), but not with ΔLAZ during 0–6 months, ΔLAZ from 18 months to 4–6 years, Hb at 6 months, or Hb at 4–6 years. No evidence of associations with motor or social–emotional development were found. These results suggest that in similar contexts, the earlier periods prior to birth and up to 18 months are more sensitive to risk factors for long‐term cognitive development associated with LAZ and Hb compared with later childhood. This may inform the optimal timing of interventions targeting improved cognitive development.