Predictors and pathways of language and motor development in four prospective cohorts of young children in Ghana, Malawi, and Burkina Faso.

Autor: Prado EL; Department of Nutrition, University of California Davis, Davis, CA, USA., Abbeddou S; Department of Nutrition, University of California Davis, Davis, CA, USA., Adu-Afarwuah S; Department of Nutrition and Food Science, University of Ghana, Legon Accra, Ghana., Arimond M; Department of Nutrition, University of California Davis, Davis, CA, USA., Ashorn P; Center for Child Health Research, School of Medicine and Tampere University Hospital, University of Tampere, Tampere, Finland.; Department of Paediatrics, Tampere University Hospital, Tampere, Finland., Ashorn U; Center for Child Health Research, School of Medicine and Tampere University Hospital, University of Tampere, Tampere, Finland., Bendabenda J; Center for Child Health Research, School of Medicine and Tampere University Hospital, University of Tampere, Tampere, Finland.; School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi., Brown KH; Department of Nutrition, University of California Davis, Davis, CA, USA.; Bill & Melinda Gates Foundation, Seattle, WA, USA., Hess SY; Department of Nutrition, University of California Davis, Davis, CA, USA., Kortekangas E; Center for Child Health Research, School of Medicine and Tampere University Hospital, University of Tampere, Tampere, Finland., Lartey A; Department of Nutrition and Food Science, University of Ghana, Legon Accra, Ghana., Maleta K; School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi., Oaks BM; Department of Nutrition, University of California Davis, Davis, CA, USA., Ocansey E; Department of Nutrition, University of California Davis, Davis, CA, USA.; Department of Nutrition and Food Science, University of Ghana, Legon Accra, Ghana., Okronipa H; Department of Nutrition, University of California Davis, Davis, CA, USA.; Department of Nutrition and Food Science, University of Ghana, Legon Accra, Ghana., Ouédraogo JB; Institut de Recherche en Sciences de la Santé/DRO, Bobo-Dioulasso, Burkina Faso., Pulakka A; Center for Child Health Research, School of Medicine and Tampere University Hospital, University of Tampere, Tampere, Finland.; Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland., Somé JW; Department of Nutrition, University of California Davis, Davis, CA, USA.; Institut de Recherche en Sciences de la Santé/DRO, Bobo-Dioulasso, Burkina Faso., Stewart CP; Department of Nutrition, University of California Davis, Davis, CA, USA., Stewart RC; Divison of Psychiatry, University of Edinburgh, Edinburgh, UK., Vosti SA; Department of Agricultural and Resource Economics, University of California Davis, Davis, CA, USA., Yakes Jimenez E; Center for Education Policy Research, University of New Mexico, Albuquerque, NM, USA., Dewey KG; Department of Nutrition, University of California Davis, Davis, CA, USA.
Jazyk: angličtina
Zdroj: Journal of child psychology and psychiatry, and allied disciplines [J Child Psychol Psychiatry] 2017 Nov; Vol. 58 (11), pp. 1264-1275. Date of Electronic Publication: 2017 May 23.
DOI: 10.1111/jcpp.12751
Abstrakt: Background: Previous reviews have identified 44 risk factors for poor early child development (ECD) in low- and middle-income countries. Further understanding of their relative influence and pathways is needed to inform the design of interventions targeting ECD.
Methods: We conducted path analyses of factors associated with 18-month language and motor development in four prospective cohorts of children who participated in trials conducted as part of the International Lipid-Based Nutrient Supplements (iLiNS) Project in Ghana (n = 1,023), Malawi (n = 675 and 1,385), and Burkina Faso (n = 1,122). In two cohorts, women were enrolled during pregnancy. In two cohorts, infants were enrolled at 6 or 9 months. In multiple linear regression and structural equation models (SEM), we examined 22 out of 44 factors identified in previous reviews, plus 12 additional factors expected to be associated with ECD.
Results: Out of 42 indicators of the 34 factors examined, 6 were associated with 18-month language and/or motor development in 3 or 4 cohorts: child linear and ponderal growth, variety of play materials, activities with caregivers, dietary diversity, and child hemoglobin/iron status. Factors that were not associated with child development were indicators of maternal Hb/iron status, maternal illness and inflammation during pregnancy, maternal perceived stress and depression, exclusive breastfeeding during 6 months postpartum, and child diarrhea, fever, malaria, and acute respiratory infections. Associations between socioeconomic status and language development were consistently mediated to a greater extent by caregiving practices than by maternal or child biomedical conditions, while this pattern for motor development was not consistent across cohorts.
Conclusions: Key elements of interventions to ensure quality ECD are likely to be promotion of caregiver activities with children, a variety of play materials, and a diverse diet, and prevention of faltering in linear and ponderal growth and improvement in child hemoglobin/iron status.
(© 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)
Databáze: MEDLINE
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