Exploring the cognitive development of children born to adolescent mothers in South Africa

Roberts, Kathryn Steventon; Smith, Colette; Toska, Elona; Cluver, Lucie; Wittesaele, Camille; Langwenya, Nontokozo; Shenderovich, Yulia; Saal, Wylene; Jochim, Janina; Chen-Charles, Jenny; Marlow, Marguerite; Sherr, Lorraine

doi:10.1002/icd.2408

Cited by 2 publications

(2 citation statements)

References 56 publications

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“…The promotion of vertical transmission prevention among adolescent mothers and adherence to ART would seemingly be beneficial to both adolescent mothers and their children, decreasing the number of children living with HIV within future generations and thus having potential benefits for child development outcomes. Overall, children born to adolescent mothers within the sample were found to perform worse on cognitive development tasks compared to the USA reference group from which the Mullen Scales of Early Learning were developed [40] and, children born to adult mothers within the sub-Saharan Africa region [45]. As such, these findings highlight the potential risks of adolescent pregnancy for the cognitive development of children born to adolescent mothers.…”

Section: Discussionmentioning

confidence: 76%

Adolescent parenthood and HIV-infection in South Africa—Associations with child cognitive development

Roberts

Sherr

Haag

et al. 2022

PLOS Glob Public Health

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HIV, both directly and indirectly, impacts child development outcomes. The most severe impacts are for children infected with HIV, and those exposed but uninfected are also shown to have challenges–though less severe. However, little is known regarding the development of children born to adolescent mothers affected by HIV. This study aims to examine cognitive development for children born to adolescent mothers, comparing those children living with HIV, those HIV exposed and uninfected (HEU) and those HIV unexposed (HU). Analyses utilise cross-sectional data from 920 adolescent mother (10–19 years)-first born child dyads residing in the Eastern Cape Province, South Africa. Participants completed detailed study questionnaires inclusive of validated and study specific measures relating to sociodemographic characteristics, HIV, and maternal and child health. Trained assessors administered standardised child development assessments (using the Mullen Scales of Early Learning) with all children. Chi-square tests and ANOVA tests were used to explore maternal and child characteristics according to child HIV status (HIV, HEU, HU) on cognitive development. Linear regression models were used to explore the cross-sectional associations between child HIV status and child cognitive development. 1.2% of children were living with HIV, 20.5% were classified as being HEU and, 78.3% were classified as HU. Overall, children living with HIV were found to perform lower across developmental domains compared to both HEU and HU groups (composite score of early learning: 73.0 vs 91.2 vs. 94.1, respectively: F = 6.45, p = 0.001). HEU children on average scored lower on all developmental domains compared to HU children, reaching significance on the gross motor domain (p<0.05). Exploratory analyses identified maternal education interruption as a potential risk factor for lower child cognitive development scores and, higher maternal age to be protective of child cognitive development scores. These exploratory findings address a critical evidence gap regarding the cognitive development of children born to adolescent mothers affected by HIV in South Africa. Analyses identify stepwise differences in the average scoring on child cognitive development domains according to child HIV status among children born to adolescent mothers affected by HIV; with children living with HIV performing worse overall. Young mothers and their children may benefit from adapted interventions aimed at bolstering child development outcomes. Targeted programming particularly among younger adolescent mothers and those experiencing education interruption may identify those families, particularly in need. Attention to maternal continuity of education and age of conception may be interventions to consider.

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Section: Discussionmentioning

confidence: 76%

Adolescent parenthood and HIV-infection in South Africa—Associations with child cognitive development

Roberts

Sherr

Haag

et al. 2022

PLOS Glob Public Health

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“…Child development was assessed by trained data collectors using a scale based on the Mullen Scales of Early Learning (Mullen, 1995). These methods are described in more detail elsewhere (Steventon Roberts et al, 2022). T-scores for four developmental domains-fine motor, visual reception, expressive language and receptive language-were combined and converted to age-standardized t-scores (range 45-155).…”

Section: Child Illnessmentioning

confidence: 99%

Associations of formal childcare use with health and human capital development for adolescent mothers and their children in South Africa: A cross‐sectional study

Cluver,

Jochim,

Mapukata

et al. 2023

Child

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AimThis study aims to investigate associations of formal childcare with maternal and child outcomes in a large sample of adolescent mothers.BackgroundForty percent of adolescent girls in Africa are mothers. Increasing evidence shows positive impacts of formal childcare use for adult women, but no known studies in the Global South examine associations for adolescent mothers and their children.MethodsWe interviewed 1046 adolescent mothers and completed developmental assessments with their children (n = 1139) in South Africa's Eastern Cape between 2017 and 2019. Questionnaires measured childcare use, maternal and child outcomes and socio‐demographic background variables. Using cross‐sectional data, associations between formal childcare use and outcomes were estimated in multivariate multi‐level analyses that accounted for individual‐level and family‐level clustering.ResultsChildcare use was associated with higher odds of being in education or employment (AOR: 4.01, 95% CIs: 2.59–6.21, p < .001), grade promotion (AOR: 2.08, 95% CIs: 1.42–3.05, p < .001) and positive future ideation (AOR: 1.58, 95% CIs: 1.01–2.49, p = .047) but no differences in mental health. Childcare use was also associated with better parenting on all measures: positive parenting (AOR: 1.66, 95% CIs: 1.16–2.38, p = .006), better parental limit‐setting (AOR: 2.00, 95% CIs: 1.37–2.93, p < .001) and better positive discipline (AOR: 1.77, 95% CIs: 1.21–2.59, p = .003). For the children, there were no differences in temperament or illness, but a significant interaction showed stronger associations between childcare use and better cognitive, language and motor scores with increasing child age (AOR: 5.04, 95% CIs: 1.59–15.96, p = .006).ConclusionsAdolescent mothers might benefit substantially from formal childcare, but causal links need to be explored further. Childcare use was also associated with improved parenting and better child development over time, suggesting positive pathways for children. At an average of $9 per month, childcare provisions for adolescent mothers may offer low‐cost opportunities to achieve high returns on health and human capital outcomes in Sub‐Saharan African contexts.

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Exploring the cognitive development of children born to adolescent mothers in South Africa

Cited by 2 publications

References 56 publications

Adolescent parenthood and HIV-infection in South Africa—Associations with child cognitive development

Adolescent parenthood and HIV-infection in South Africa—Associations with child cognitive development

Associations of formal childcare use with health and human capital development for adolescent mothers and their children in South Africa: A cross‐sectional study

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