Determinants of cognitive function in childhood: A cohort study in a middle income context

Santos, Darci Neves dos; Assis, Ana Marlúcia Oliveira; Bastos, Ana Cecília de Sousa; Santos, Lígia Amparo da Silva; Santos, Celso A. S.; Strina, Agostino; Prado, Matildes da Silva; Almeida-Filho, Naomar; Rodrigues, Laura C.; Barreto, Maurício L.

doi:10.1186/1471-2458-8-202

Cited by 104 publications

(110 citation statements)

References 40 publications

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“…On the contrary, several studies have reported that socioeconomic status is a strong predictor of both nutritional status (Brooks-Gunn and Duncan, 1997;Ndukwu et al, 2013) and outcomes in children (Bradley and Corwyn, 2002;Santos et al, 2008). The lack of an association between household wealth and child outcomes is not without precedence; an earlier study among infants living within the same context (Abubakar et al, 2008) has reported similar findings.…”

Section: Discussionmentioning

confidence: 96%

Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Kitsao-Wekulo¹,

Holding²,

Taylor³

et al. 2015

Prenatal and Childhood Nutrition

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Adequate nutrition is fundamental to the development of a child's full potential. However, the extent to which malnutrition affects developmental and cognitive outcomes in the midst of co-occurring risk factors remains largely understudied. We sought to establish if the effects of nutritional status varied according to diverse background characteristics as well as to compare the relative strength of the effects of poor nutritional status on language skills, motor abilities, and cognitive functioning at school age. This cross-sectional study was conducted among school-age boys and girls resident in Kilifi District in Kenya. We hypothesized that the effects of area of residence, school attendance, household wealth, age and gender on child outcomes are experienced directly and indirectly through child nutritional status. The use of structural equation modeling (SEM) allowed the disaggregation of the total effect of the explanatory variables into direct effects (effects that go directly from one variable to another) and indirect effects. Each of the models tested for the four child outcomes had a good fit. However, the effects on verbal memory apart from being weaker than for the other outcomes, were not mediated through nutritional status. School attendance was the most influential predictor of nutritional status and child outcomes. The estimated models demonstrated the continued importance of child nutritional status at school-age.Keywords: nutritional status, school-age children, structural equation modeling, direct and indirect effects, co-occurring risk factors, cognitive outcomes INTRODUCTIONWhile the literature provides evidence that the negative effects of early malnutrition persist to school-age (Pollitt et al., 1996), there are several significant knowledge gaps. First, despite evidence that the impact of nutrition varies across different neurocognitive domains, there have been few studies investigating this area, especially in middle childhood. And yet at school age, children are exposed to more differential experiences and acquire more sophisticated abilities across various cognitive domains (Fischer and Bullock, 1984). Second, there is a complex inter-related relationship between poverty, nutritional status and neurocognitive outcomes. Not only do the constraints of low income in deprived settings create practical barriers to good nutrition; additional socio-environmental factors reinforce the effects of this deprivation (Engle and Black, 2008). Poor nutritional status at this age may have long-term negative consequences and restrict development of a child's full potential. This is therefore a critical period for investigating the link between malnutrition and developmental outcomes, especially within a multiple risk context.In many developing countries, particularly in sub-Saharan Africa, linear growth retardation, or stunting, a manifestation of chronic protein-energy malnutrition (PEM), is highly prevalent, with rates as high as 38% (de Onis et al., 2012). Various individual and environmental variabl...

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Section: Discussionmentioning

confidence: 96%

Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Kitsao-Wekulo¹,

Holding²,

Taylor³

et al. 2015

Prenatal and Childhood Nutrition

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“…The cognitive development in children born with VLBW, particularly those with less severe complications, would be positively influenced by consistent responsiveness during first childhood 17 . Perhaps keeping the association between maternal education and cognitive impairment in the final model pervade through mechanisms related to intermediate and proximal factors not considered in this model, such as stimulation of the child by the parents or guardians, supply of toys and games, organization of a favorable environment and parental practices and styles 3 . Unlike other studies on cognition in children 3 , family income was not significantly associated with cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps keeping the association between maternal education and cognitive impairment in the final model pervade through mechanisms related to intermediate and proximal factors not considered in this model, such as stimulation of the child by the parents or guardians, supply of toys and games, organization of a favorable environment and parental practices and styles 3 . Unlike other studies on cognition in children 3 , family income was not significantly associated with cognitive impairment. Perhaps the homogeneity of the income partially explains this result.…”

Section: Discussionmentioning

confidence: 99%

“…Studies held on the possible determinants of cognitive function in the childhood of children born at different gestational ages imply unfavorable socioeconomic conditions and low birth weight as factors negatively associated with cognitive performance in preschool children 3 . The singularity of the preterm newborn population does not allow generalizing the research results on the evolution of cognitive functioning in the general pediatric population for schoolchildren born prematurely 4 .…”

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confidence: 99%

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Risk factors for cognitive impairment in school-age children born preterm: application of a hierarchical model

Rodrigues¹,

Mello

Silva

et al. 2012

Arq. Neuro-Psiquiatr.

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The purpose was to analyze factors associated with cognitive impairment in very low birth weight (VLBW) children born preterm. A prospective cohort of 65 VLBW children was assessed at the age of eight years using the Wechsler Intelligence Scale for Children. A model for the relationship of variables with the cognitive impairment outcome attributed hierarchical levels: distal (socioeconomic variables), intermediate I and II (perinatal and neonatal variables, post-neonatal variables) and proximal (child health and psychosocial stimulation). A multivariate logistic regression was performed. In the multivariate hierarchical logistic regression, the maternal education (OR=0.77, 95%CI 0.63-0.94) and number of prenatal visits (OR=0.73, 95%CI 0.54-0.99) showed a protective association, but the male (OR=7.3, 95%CI 1.54-35.3) was associated with worse results. The VLBW children cognitive performance in the age of eight years benefits from more educated mothers, better prenatal care, and the baby gender as female.

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“…Low birth weight has been associated with higher nutritional risk at age 12 months, delayed cognitive development, delayed learning in preschoolers and schoolers, sensory deficits, respiratory diseases, high blood pressure in childhood and adolescence, risk of coronary artery disease, diabetes type 2, abdominal obesity, metabolic syndrome, and adulthood hypertension [4][5][6] . The literature on LBW-related factors is vast.…”

Section: Introductionmentioning

confidence: 99%

Physical intimate partner violence and low birth weight in newborns from primary health care units of the city of Rio de Janeiro

Mezzavilla

Hasselmann

2016

Rev. Nutr.

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ResultsSome (7.1%) babies were born underweight, and 33.6% of the mothers had been exposed to physical intimate partner violence. Physical intimate partner violence was significantly associated with low birth weight (OR=3.69; 95%CI=1. 57-8.66). Notably, the odds of low birth weight increase with the severity of violence. ConclusionThese findings draw attention to the consequences of physical intimate partner violence on the nutritional status of newborns and emphasize the need of greater attention during prenatal care to improve women's quality of life and to reduce the rate of low birth weight.Keywords: Birth weight. Nutrition. Spouse abuse. Violence. R E S U M O ObjetivoInvestigar a associação da violência física entre parceiros íntimos e a ocorrência de baixo peso ao nascer. Métodos O período de tempo investigado referiu-se aos 12 meses anteriores à entrevista. A violência física entre parceiros íntimos foi analisada de maneira dicotômica e cumulativa. As associações entre violência física entre parceiros íntimos e baixo peso ao nascer foram verificadas via modelos de regressão logística, mediante estimativas de razões de chances brutas e ajustadas e seus respectivos intervalos de 95% de confiança. ResultadosNasceram com baixo peso 7,1% das crianças e foram expostas à violência física entre parceiros íntimos 33,6% das mulheres estudadas. A violência física entre parceiros íntimos foi significativamente associada com o baixo peso ao nascer (OR=3,69; IC95%=1,66

show abstract

Determinants of cognitive function in childhood: A cohort study in a middle income context

Cited by 104 publications

References 40 publications

Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Risk factors for cognitive impairment in school-age children born preterm: application of a hierarchical model

Physical intimate partner violence and low birth weight in newborns from primary health care units of the city of Rio de Janeiro

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