Evidence map›Paper›PMID 30528471›Full record

SynthesisLancet (London, England)2018

Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis.

Gracia Fellmeth, Kelly Rose-Clarke, Chenyue Zhao, Laura K Busert, Yunting Zheng, Alessandro Massazza, Hacer Sonmez, Ben Eder, Alice Blewitt, Wachiraya Lertgrai and 9 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 246 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
246citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

246 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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186 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Gracia FellmethNational Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
Kelly Rose-ClarkeDepartment of Global Health and Social Medicine, King's College London, London, UK.
Chenyue ZhaoDepartment of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA.
Laura K BusertGreat Ormond Street Institute of Child Health, University College London, London, UK.
Yunting ZhengDepartment of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China.
Alessandro MassazzaDepartment of Clinical, Educational and Health Psychology, University College London, London, UK.
Hacer SonmezFaculty of Health Sciences, University of Bristol, Bristol, UK.
Ben EderInstitute for Global Health, University College London, London, UK.
Alice BlewittInstitute for Global Health, University College London, London, UK.
Wachiraya LertgraiFaculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Miriam OrcuttInstitute for Global Health, University College London, London, UK.
Katharina RicciInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany.
Olaa Mohamed-AhmedNational Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
Rachel BurnsInstitute for Global Health, University College London, London, UK.
Duleeka KnipeDepartment of Population Science, University of Bristol, Bristol, UK.
Sally HargreavesInstitute for Infection and Immunity, St George's, University of London, London, UK; International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, London, UK.
Therese HeskethInstitute for Global Health, University College London, London, UK; Centre for Global Health, School of Medicine, Zhejiang University, Hangzhou, China.
Charles OpondoNational Perinatal Epidemiology Unit, University of Oxford, Oxford, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Delan DevakumarInstitute for Global Health, University College London, London, UK. Electronic address: d.devakumar@ucl.ac.uk.

Funding

Scaling Community-Clinical Linkage Models to Address Diabetes and Hypertension Disparities in the Southeastern U.S.U54MD000538 · NIMHD · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI KWON, SIMONA, TRINH-SHEVRIN, CHAU · 2017 to 2022
$11.3M
NIMHD NIH HHS U54 MD000538Wellcome Trust 209993/Z/17/Z
6 · The paper itself

Abstract

backgroundGlobally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs).

methodsFor this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871.

findingsOur search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27-1·82]; SMD 0·16 [0·10-0·21]), anxiety (RR 1·85 [1·36-2·53]; SMD 0·18 [0·11-0·26]), suicidal ideation (RR 1·70 [1·28-2·26]), conduct disorder (SMD 0·16 [0·04-0·28]), substance use (RR 1·24 [1·00-1·52]), wasting (RR 1·13 [1·02-1·24]) and stunting (RR 1·12 [1·00-1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains.

interpretationParental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people.

fundingWellcome Trust.

Indexed as

Adolescent HealthChild HealthEmigration and ImmigrationAdolescentAnxietyChildChild, AbandonedConduct DisorderDepressionDeveloping CountriesHumansIncomeNutrition DisordersParentsSubstance-Related DisordersSuicidal Ideation

Identifiers

PMID30528471
PMCPMC6294734

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.