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)

Natalia E Poveda; Fernando P Hartwig; Cesar G Victora; Linda S Adair; Fernando C Barros; Santosh K Bhargava; Bernardo L Horta; Nanette R Lee; Reynaldo Martorell; Mónica Mazariegos; Ana M B Menezes; Shane A Norris; Linda M Richter; Harshpal Singh Sachdev; Alan Stein; Fernando C Wehrmeister; Aryeh D Stein; COHORTS Group

doi:10.1093/jn/nxab096

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)

J Nutr. 2021 Aug 7;151(8):2342-2352. doi: 10.1093/jn/nxab096.

Authors

Natalia E Poveda¹, Fernando P Hartwig^{2

3}, Cesar G Victora², Linda S Adair⁴, Fernando C Barros⁵, Santosh K Bhargava⁶, Bernardo L Horta², Nanette R Lee⁷, Reynaldo Martorell^{1

8}, Mónica Mazariegos⁹, Ana M B Menezes², Shane A Norris^{10

11}, Linda M Richter¹², Harshpal Singh Sachdev¹³, Alan Stein^{14

15}, Fernando C Wehrmeister², Aryeh D Stein^{1

8}; COHORTS Group

Affiliations

¹ Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA.
² Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
³ Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
⁴ Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁵ Postgraduate Program in Health and Behaviour, Universidade Católica de Pelotas, Pelotas, Brazil.
⁶ Consultant Pediatrician and Founder New Delhi Birth Cohort, New Delhi, India.
⁷ USC-Office of Population Studies Foundation, Inc, University of San Carlos - TC, Talamban, Cebu City, Cebu, Philippines.
⁸ Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA.
⁹ INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala.
¹⁰ SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
¹¹ Global Health Research Institute, School of Human Development and Health & NIHR Southampton Biomedical Research Centre, University of Southampton, United Kingdom.
¹² DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.
¹³ Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India.
¹⁴ Department of Psychiatr, University of Oxford, Oxford, United Kingdom.
¹⁵ MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

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.

Keywords: cohort studies; conditional height; conditional relative weight; growth; intelligence quotient; schooling attainment.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Birth Cohort*
Child, Preschool
Developing Countries*
Educational Status
Female
Humans
Infant, Newborn
Intelligence
Male
Prospective Studies

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)

Authors

Collaborators

Affiliations

Abstract

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MeSH terms

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