The effect of cumulative early life adversities, and their differential mediation through hair cortisol levels, on childhood growth and cognition: Three-year follow-up of a birth cohort in rural India

Abstract

Background: Early adversities negatively impact children’s growth and development, putatively mediated by chronic physiological stress resulting from these adverse experiences. We aimed to estimate the associations between prospectively measured cumulative early adversities with growth and cognition outcomes in rural Indian preschool children and to explore if hair cortisol concentration (HCC), a measure of chronic physiological stress, mediated the above association. Methods: Participants were recruited from the SPRING cRCT in rural Haryana, India. Adversities experienced through pregnancy and the first year of life were measured in 1304 children at 12-months. HCC was measured at 12-months in 845 of them. Outcome measures were height-for-age-z-score (HAZ), weight-for-age-z-score (WAZ) and cognition, measured in 1124 children followed up at 3-years. Cognition was measured using a validated tablet-based gamified tool named DEEP. Results: Cumulative adversities at 12-months were inversely associated with all outcomes measures at 3-years. Each unit increase in adversity score led to a decrease of 0·08 units [95% confidence interval (CI):-0·11,-0·06] in DEEP-z-score; 0·12 units [-0·14,-0·09] in HAZ and 0·11 units [-0·13,-0·09] in WAZ. 12-month HCC was inversely associated with DEEP-z-score (-0·09 [-0·16,-0·01]) and HAZ (-0·12 [-0·20,-0·04]), but the association with WAZ was not significant (p = 0·142). HCC marginally mediated the association between cumulative adversities and HAZ (proportion mediated = 0·06, p = 0·014). No evidence of mediation was found for the cognition outcome. Conclusions: Cumulative early adversities and HCC measured at 12-months have persistent negative effects on child growth and cognition at 3-years. The association between adversities and these two child outcomes were differentially mediated by HCC, with no evidence of mediation observed for the cognitive outcome. Future studies should focus on other stress biomarkers, and alternate pathways such as the immune, inflammation and cellular ageing pathways, to unpack key mechanisms underlying the established relationship between early adversities and poor child outcomes.

The effect of cumulative early life adversities, and their differential mediation through hair cortisol levels, on childhood growth and cognition: Three-year follow-up of a birth cohort in rural India

“…There was a significant inverse association between cumulative adversity total score at 12 months and cognition at 3-years (Figure 2 and Extended Data-Table 1 39 ). This was approximately linear with no threshold or ceiling effects (Figure 2A); each unit increase in adversity being associated with a decrease of 0•08 units in DEEP z-score (95% CI: -0•11, -0•06; p-trend < 0•001).…”

“…39 ); each additional adversity experienced within these domains was associated with a decrease of 0•19 (95% CI: -0•24, -0•14; p < 0•001) and 0•18 (95% CI: -0•25, -0•10; p < 0•001) units in DEEP z-scores. Maternal stress led to a…”

Psychometric soundness and predictive factors of the NCAST Parent–Child Interaction Teaching Scale in urban Chinese population

“…It is generally recognized that nurturing care is crucial for children's short‐term and long‐term development, including attachment (Ainsworth, 1974; Barnard et al, 1989), brain growth (Cusick & Georgieff, 2016), social and cognitive development (Banerjee & Tamis‐Lemonda, 2007; Mukherjee et al, 2022), clinical outcome (Wan et al, 2013; Worobey et al, 2009), academic competence (Stright et al, 2008) and health and well‐being in adulthood (Black et al, 2017). Among all the critical factors of nurturing care, sensitive and responsive parent–child interaction promotes secure attachment, which lies the foundation for children to explore their surroundings (Kelly et al, 2008).…”