Evidence map›Paper›PMID 31585969›Full record

SynthesisBMJ open2019

Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries.

Ayesha Sania, Christopher R Sudfeld, Goodarz Danaei, Günther Fink, Dana C McCoy, Zhaozhong Zhu, Mary C Smith Fawzi, Mehmet Akman, Shams E Arifeen, Aluisio J D Barros and 35 more

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

Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 5 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

63 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Early Marriage, Preterm Birth, and School Dropout: An Intergenerational Cycle of Risk?American journal of human biology : the official journal of the Human Biology Council · 2025
    Pooled it
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  4. Interventions to improve sanitation for preventing diarrhoea.The Cochrane database of systematic reviews · 2023
    Pooled it
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  8. The Effects of Malaria in Pregnancy on Neurocognitive Development in Children at 1 and 6 Years of Age in Benin: A Prospective Mother-Child Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Trial
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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

45 authors.

Ayesha SaniaICAP and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York city, New York, USA ays328@mail.harvard.edu.
Christopher R SudfeldDepartment of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
Goodarz DanaeiDeaprtment of Global Health and Population, and Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
Günther FinkHousehold Economics and Health System Research Unit, Schweizerisches Tropen- und Public Health-Institut, Basel, Switzerland.
Dana C McCoyHarvard Graduate School of Education, Harvard University, Cambridge, Massachusetts, USA.
Zhaozhong ZhuDepartments of Epidemiology and Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
Mary C Smith FawziDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Mehmet AkmanDepartment of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey.
Shams E ArifeenMaternal and Child Health Division, ICDDR,B, Dhaka, Bangladesh.
Aluisio J D BarrosPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
David BellingerDepartment of Neurology, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA.
Maureen M BlackDepartment of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Alemtsehay BogaleNutrition and Scientific Affairs, The Nature's Bounty Co, Ronkonkoma, New York, USA.
Joseph M BraunBrown University School of Public Health, Providence, Rhode Island, USA.
Nynke van den BroekMaternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UK.
Verena CarraraDepartment of Maternal and Child Health, Shoklo Malaria Research Unit, Mae Sot, Thailand.
Paulita DuazoOffice of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines.
Christopher DugganCenter for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
Lia C H FernaldCommunity Health Sciences, School of Public Health, University of California, Berkeley, California, USA.
Melissa GladstoneWomen and Children's Health, University of Liverpool, Institute of Translational Medicine, Liverpool, UK.
Jena HamadaniMaternal and Child Health Division, ICDDR,B, Dhaka, Bangladesh.
Alexis J HandalCollege of Population Health, University of New Mexico, Albuquerque, New Mexico, USA.
Siobán HarlowDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Melissa HidroboPoverty Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.
Chris KuzawaDepartment of Anthropology, Northwestern University, Evanston, Illinois, USA.
Ingrid KvestadRegional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway.
Lindsey LocksDepartment of Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
Karim ManjiDepartment of Pediatrics and Child Health, Muhibili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Honorati MasanjaIfakara Health Institute, Dar es Salam, Tanzania.
Alicia MatijasevichDepartamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brasil.
Christine McDonaldChildren's Hospital Oakland Research Institute, UCSF Benioff Children's Hospital, Oakland, California, USA.
Rose McGreadyFaculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mae Sot, Thailand.
Arjumand RizviPediatrics and Child Health, Aga Khan Medical University, Karachi, Pakistan.
Darci SantosDepartment of Collective Health, Universidade Federal da Bahia, Salvador, Brazil.
Leticia SantosDepartment of Collective Health, Universidade Federal da Bahia, Salvador, Brazil.
Dilsad SaveDepartment of Public Health, Marmara University School of Medicine, Istanbul, Turkey.
Roger ShapiroDepartment of Immunology and Infectious Disease, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
Barbara StoeckerDepartment of Nutritional Sciences, Oklahoma State University College of Human Environmental Sciences, Stillwater, Oklahoma, USA.
Tor A StrandDepartment of Laboratory Medicine, Sykehuset Innlandet Helseforetaket, Brumunddal, Norway.ORCID 0000-0002-4038-151X
Sunita TanejaCentre for Health Research and Development, Society for Applied Studies, New Delhi, India.
Martha-Maria Tellez-RojoDivision of Research on Public Health, National Institute of Perinatology, Mexico City, Mexico.
Fahmida TofailNutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh.
Aisha K YousafzaiDepartment of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
Majid EzzatiMRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
Wafaie FawziDeaprtment of Global Health and Population, Epidemiology, and Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.

Funding

University of Michigan ERC-supplement (TRT)T42OH008455 · OH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI NEITZEL, RICHARD L · 2005 to 2025
$32.3M
ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI Elizabeth Austen Lawson, Takara Leah Stanley · 1994 to 2026
$31.6M
Global HIV Implementation Science Research Training Grant RenewalT32AI114398 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Yael R Hirsch-Moverman · 2014 to 2026
$4.1M
Medical Research Council MR/L01341X/1NIAID NIH HHS T32 AI114398NIDDK NIH HHS P30 DK040561NIOSH CDC HHS T42 OH008455
6 · The paper itself

Abstract

objectiveTo determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).

designMeta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data. DATA SOURCES: We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study. ANALYSES: Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses.

resultsWe retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs.

conclusionsDifferential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.

Indexed as

Child DevelopmentCognitionMotor SkillsChildChild, PreschoolDeveloping CountriesDevelopmental DisabilitiesHumansInfantLanguage DevelopmentProtective FactorsRisk Factorsaccess to clean wateraccess to sanitationbreast feedingcognitive developmentdiarrhoeaearly life risk factorslanguage developmentmaternal anaemia and anaemia in infancymaternal educationmaternal short staturemotor developmentpaternal educationpretermSGA

Identifiers

PMID31585969
PMCPMC6797384

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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.