Early-life stature, preschool cognitive development, schooling attainment, and cognitive functioning in adulthood: a prospective study in four birth cohorts
Early-life stature, preschool cognitive development, schooling attainment, and cognitive functioning in adulthood: a prospective study in four birth cohorts
Background: nutrition is important for growth and brain development and therefore cognitive ability. Growth faltering in early childhood, an important indicator of early adversity, is associated with poorer developmental outcomes, some into adulthood, but this association probably reflects early-life deprivation. We aimed to investigate the associations between early-life stature, child IQ, and adult IQ.
Methods: in this cohort study, we used prospective longitudinal data collected in four birth cohorts from Brazil (born in 1993), Guatemala (born in 1969-77), the Philippines (born in 1983-84), and South Africa (born in 1990). Using multivariable linear models, we estimated the relative contributions of early-life stature, child IQ, and schooling (highest school year completed) to adult IQ, including interaction effects among the early-childhood measures and schooling.
Findings: we included 2614 individuals in the analysis. Early-life stature was associated with adult IQ (range across eight site-by-sex groups -0·14 to 3·17 IQ points) and schooling (-0·05 to 0·77 years) per height-for-age Z-score. These associations were attenuated when controlling for child IQ (-0·86 to 1·72 for adult IQ and -0·5 to 0·60 for schooling). The association of early-life stature with adult IQ was further attenuated when controlling for schooling (-1·86 to 1·21). Child IQ was associated with adult IQ (range 3·91 to 10·02 points) and schooling (0·25 to 1·30 years) per SD of child IQ in all groups; these associations were unattenuated by the addition of early-life stature to the models. The interaction between schooling and child IQ, but not that between schooling and early-life stature, was positively associated with adult IQ across groups.
Interpretation: the observed associations of early-life stature with adult IQ and schooling varied across cohorts and sexes and explained little variance in adult IQ beyond that explained by child IQ. These findings suggest that interventions targeted at growth for health and early development are important. Our results are consistent with the inference that improving long-term cognitive outcomes might require interventions that more specifically target early cognitive ability.
Funding: Bill & Melinda Gates Foundation.
e95-e104
Stein, Aryeh D.
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Adair, Linda S.
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Donati, Georgina
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Wray, Charlotte
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Richter, Linda M.
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Norris, Shane A.
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Stein, Alan
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Martorell, Reynaldo
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Ramirez-Zea, Manuel
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Menezes, Ana M.B.
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Murray, Joseph
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Victora, Cesar
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Lee, Nanette
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Bas, Isabelita
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11 January 2023
Stein, Aryeh D.
5ee08d0c-2313-4d74-bfcf-49e9bfabc36d
Adair, Linda S.
29681e3c-cb95-4b98-9e3f-2e7e0cc1c2a8
Donati, Georgina
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Wray, Charlotte
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Richter, Linda M.
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Norris, Shane A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Stein, Alan
ba341b04-0b18-411a-9926-44182a628a1d
Martorell, Reynaldo
d120786d-e651-446d-a96a-d175de202d5b
Ramirez-Zea, Manuel
fc06cfd0-de37-4df6-aa63-5dfbf0d31d43
Menezes, Ana M.B.
5839aff3-6fcf-42a7-a508-b5faca626eb8
Murray, Joseph
9e1fabd2-973d-4ecb-80bf-5ebc50d2a421
Victora, Cesar
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Lee, Nanette
005c4677-dcd4-4e0e-a7b5-4442385f1c01
Bas, Isabelita
31fc2cff-9240-492e-a0c6-57e5821b6370
Stein, Aryeh D., Adair, Linda S. and Donati, Georgina
,
COHORTS Group
(2023)
Early-life stature, preschool cognitive development, schooling attainment, and cognitive functioning in adulthood: a prospective study in four birth cohorts.
The Lancet Global Health, 11 (1), .
(doi:10.1016/S2214-109X(22)00448-X).
Abstract
Background: nutrition is important for growth and brain development and therefore cognitive ability. Growth faltering in early childhood, an important indicator of early adversity, is associated with poorer developmental outcomes, some into adulthood, but this association probably reflects early-life deprivation. We aimed to investigate the associations between early-life stature, child IQ, and adult IQ.
Methods: in this cohort study, we used prospective longitudinal data collected in four birth cohorts from Brazil (born in 1993), Guatemala (born in 1969-77), the Philippines (born in 1983-84), and South Africa (born in 1990). Using multivariable linear models, we estimated the relative contributions of early-life stature, child IQ, and schooling (highest school year completed) to adult IQ, including interaction effects among the early-childhood measures and schooling.
Findings: we included 2614 individuals in the analysis. Early-life stature was associated with adult IQ (range across eight site-by-sex groups -0·14 to 3·17 IQ points) and schooling (-0·05 to 0·77 years) per height-for-age Z-score. These associations were attenuated when controlling for child IQ (-0·86 to 1·72 for adult IQ and -0·5 to 0·60 for schooling). The association of early-life stature with adult IQ was further attenuated when controlling for schooling (-1·86 to 1·21). Child IQ was associated with adult IQ (range 3·91 to 10·02 points) and schooling (0·25 to 1·30 years) per SD of child IQ in all groups; these associations were unattenuated by the addition of early-life stature to the models. The interaction between schooling and child IQ, but not that between schooling and early-life stature, was positively associated with adult IQ across groups.
Interpretation: the observed associations of early-life stature with adult IQ and schooling varied across cohorts and sexes and explained little variance in adult IQ beyond that explained by child IQ. These findings suggest that interventions targeted at growth for health and early development are important. Our results are consistent with the inference that improving long-term cognitive outcomes might require interventions that more specifically target early cognitive ability.
Funding: Bill & Melinda Gates Foundation.
Text
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e-pub ahead of print date: 13 December 2022
Published date: 11 January 2023
Additional Information:
Funding Information:
Funding for this analysis came from the Bill & Melinda Gates Foundations (OPP1164115). Additional members of the COHORTS group at the time of this work include Alysse Kowalski, Ann DiGirolamo, Gaia Scerif, Feziwe Mpondo, Lukhanyo Nyati, Clive Osmond, Judith Rafaelita Borja, Delia Carba, Tita Lorna Perez, Sonny Agustin Bechavda, Delia Belleza, Maria F Kroker-Lobos, Jithin S Varghese, Fernando C Barros, Fernando P Hartwig, Bernardo L Horta, and Fernando C Wehrmeister.
Identifiers
Local EPrints ID: 473736
URI: http://eprints.soton.ac.uk/id/eprint/473736
ISSN: 2214-109X
PURE UUID: 14104f41-fae2-4187-8786-263c6f2c4c46
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Date deposited: 30 Jan 2023 19:52
Last modified: 06 Jun 2024 02:06
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Contributors
Author:
Aryeh D. Stein
Author:
Linda S. Adair
Author:
Georgina Donati
Author:
Charlotte Wray
Author:
Linda M. Richter
Author:
Alan Stein
Author:
Reynaldo Martorell
Author:
Manuel Ramirez-Zea
Author:
Ana M.B. Menezes
Author:
Joseph Murray
Author:
Cesar Victora
Author:
Nanette Lee
Author:
Isabelita Bas
Corporate Author: COHORTS Group
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