Evidence map›Paper›PMID 41063053›Full record

ArticleBMC pediatrics2025

Association of biological, socioeconomic, and environmental factors with child development at two years of age in Bangladesh, Pakistan, and Tanzania: results from the AMANHI-ACT study.

Ambreen Nizar, Rasheda Khanam, Jamila Khalfan Ali, Muhammad Imran Nisar, Fahmida Tofail, Bishara Ali Alawi, Nadia Ansari, Salahuddin Ahmed, Usha Dhingra, Fariha Shaheen and 20 more

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Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

30 authors.

Ambreen NizarDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Rasheda KhanamDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Jamila Khalfan AliCenter for Public Health Kinetics, Zanzibar, Tanzania.
Muhammad Imran NisarDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Fahmida TofailInternational Center for Diarrheal Disease Research, Mohakhali, Dhaka, Bangladesh.
Bishara Ali AlawiCenter for Public Health Kinetics, Zanzibar, Tanzania.
Nadia AnsariDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Salahuddin AhmedProjahnmo Research Foundation, Dhaka, Bangladesh.
Usha DhingraCenter for Public Health Kinetics, New Delhi, India.
Fariha ShaheenDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Abrarul Haque AsifProjahnmo Research Foundation, Dhaka, Bangladesh.
Arup DuttaCenter for Public Health Kinetics, New Delhi, India.
Muhammad Farrukh QaziDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Sayedur RahmanDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Mayassa AlyZanzibar Health Research Institute, Zanzibar, Tanzania.
Usma MehmoodDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Nabidul Haque ChowdhuryProjahnmo Research Foundation, Dhaka, Bangladesh.
Fahad AftabCenter for Public Health Kinetics, Zanzibar, Tanzania.
Shahira ShahidDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Mohammod ShahidullahBangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Fatma M KaboleMinistry of Health, Zanzibar, Tanzania.
Farzana BegumDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
Pamela J SurkanDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Anupama VermaDepartment of Pediatrics, Lala Lajpat Rai Memorial Medical College, Uttar Pradesh, Meerut, India.
Alexander ManuLondon School of Hygiene and Tropical Medicine, Keppel Street, London , UK.
Sachiyo YoshidaDepartment of Sexual, Reproductive, Maternal, Child, Adolescent and Ageing, World Health Organization, Geneva, Switzerland. yoshidas@who.int.
Rajiv BahlIndian Council of Medical Research, New Delhi, India.
Sunil SazawalCenter for Public Health Kinetics, New Delhi, India.
Abdullah H BaquiDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Fyezah JehanDepartment of Pediatrics and Child Health, The Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.

Funding

Bill and Melinda Gates Foundation,United States 64438World Health Organization 001
6 · The paper itself

Abstract

backgroundThe first 1,000 days of life, spanning pregnancy to two years, are critical for development. We investigated the association of maternal, socioeconomic, environmental, nutritional, and childhood characteristics with cognitive, motor, and language development at two years of age.

methodsThe AMANHI-ACT study enrolled pregnant women between 8 and 19 weeks of gestation from Bangladesh, Pakistan, and Tanzania. Data was collected on sociodemographic factors, maternal BMI and co-morbidities during pregnancy, and weight and gestational age at birth. Child characteristics included vaccination history, infections, and physical growth at predefined intervals up to two years. Child development at two years was assessed using the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III). The home environment was assessed using the Home Observation for Measurement of the Environment Infant-Toddler (HOME-IT) tool. We performed linear regression and reported site-adjusted regression coefficients with 95% confidence intervals.

resultsWe assessed 3,062 children at two years of age to identify factors associated with their cognitive, language, and motor development scores. Cognitive scores were significantly lower among children whose mothers had no formal education (Adjusted coefficient = -3.8; 95% CI: -5.8, -1.8) and those who had not received any vaccinations (Adjusted coefficient = -6.0; 95% CI: -9.3, -2.6). Language development was similarly affected: children with mothers who had no education (Adjusted coefficient = -4.7; 95% CI: -6.8, -2.5) or only primary-level education (Adjusted coefficient = -4.5; 95% CI: -6.5, -2.5) showed markedly lower scores. Language scores were also reduced in children whose fathers had no education (Adjusted coefficient = -2.4; 95% CI: -4.2, -0.5) or only primary education (Adjusted coefficient = -2.4; 95% CI: -4.1, -0.6). For motor development, children who were stunted (Adjusted coefficient = -2.2; 95% CI: -2.9, -1.4), wasted (Adjusted coefficient = -2.8; 95% CI: -4.3, -1.4), or unvaccinated (Adjusted coefficient = -4.7; 95% CI: -8.0, -1.4) at two years exhibited significantly lower scores.

conclusionPreterm births, vaccination history, parental education, and physical growth significantly affected the first 1000 days of child development, thus identifying areas for targeted intervention to optimize long-term health outcomes in LMICs.

Indexed as

Child DevelopmentAdultBangladeshChild, PreschoolCognitionEducational StatusFemaleHumansInfantInfant, NewbornLanguage DevelopmentMaleMotor SkillsPakistanPregnancySocioeconomic FactorsBangladeshBayley-IIICognitionDevelopmentLanguageMotorPakistanTanzania

Identifiers

PMID41063053
PMCPMC12505821

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LicenceCC BY-NC-ND
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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.