Linear growth and child development during early childhood in Bangladesh Öffentlichkeit
Wagh, Kaustubh (Spring 2019)
Published
Abstract
Introduction: We assessed the longitudinal relationships between length and motor, and cognitive development among children less than 24 mo in rural Bangladesh.
Design: Prospective longitudinal cohort study with structured home interviews during pregnancy and 3 , 9, 16 and 24 mo after delivery.
Setting: Two rural sub-districts (Karimganj; Katiadi) of Kishoreganj district, Bangladesh.
Subjects: Mother-infant dyads.
Results: We observed decrease in mean length-for-age Z (LAZ) scores from -1.1 at 3 mo to -2.3 at 24 mo. Similar trend was observed in head circumference z-scores (HCZ) although BMI z-scores (BMIZ) remained constant between 3 to 24 mo. For one unit increase in LAZ score at 3 mo, the motor z-score at 9 mo increased by 0.10 (95% CI 0.07, 0.14). Similarly, one unit change in LAZ score at 9 mo and 16 mo was associated with increase in motor z-scores at 16 mo and 24 mo by 0.16 (95% CI 0.12, 0.20) and 0.12 (95% CI 0.08, 0.16) respectively. Additionally, for one unit increase in LAZ score at 9 and 16 mo, the cognitive z-score at 16 and 24 mo was increased by 0.12 (95% CI 0.08, 0.16) and 0.11 (95% CI 0.07, 0.16) respectively. Thus, increase mean motor and cognitive scores was observed with decrease in the severity of stunting at specified time-point as well as with age of children. These measures were adjusted maternal education, BMI z-scores of children, initiation of complementary feeding along with wave of enrollment, and sub-district of origin.
Conclusions: Our analysis showed that lagged LAZ score was significantly associated with both motor and cognitive development during the first 24 mo of life. This association was highest when outcome is measured at 16 mo. Thus, reduction in the prevalence of stunting before 16 mo will have significant effect on motor as well as cognitive development during the first 24 mo of a child’s life.
Table of Contents
TABLE OF CONTENTS
Chapter I: Literature Review......................................................................................1
Chapter II: Manuscript ..............................................................................................6
2.1 Abstract........................................................................................................6
2.2 Introduction .................................................................................................7
2.3 Methods .......................................................................................................8
2.3.1 The original intervention...............................................................8
2.3.2 Recruitment of the cohort and timing of assessments...................9
2.3.3 Measurement of length…..............................................................9
2.3.4 Measurement of development……………………….…………..9
2.3.5 Measurement of other variables………………………...……...10
2.3.6 Data Manipulation ………….………….………….…………...10
2.3.7 Statistical Analysis ……………………………………..……...11
2.4 Results…………………………………....................................... 13
2.5 Discussion…………………......................................................... 16
2.6 Tables …………………………………………………............... 20
2.7 Figures …………………………….............................................. 27
Chapter 4: Implications ........................................................................................... 29
4.1 Summary....................................................................................... 29
4.2 Public Health Implications………. ..............................................30
4.2.1 Future Directions ...................................................................... 30
References …………………………………………………………………………. 32
Appendices ………………………………………………………………………… 39
Supplementary Tables…................................................................................. 39
IRB Approval Letter ....................................................................................... 41
Study Protocol Approval ................................................................................ 42
Assessment ……………................................................................................. 44
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