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. 2020 Jan 24;15(1):e0227839.
doi: 10.1371/journal.pone.0227839. eCollection 2020.

Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study

Md Ashraful Alam  1 , Stephanie A Richard  2 , Shah Mohammad Fahim  1 , Mustafa Mahfuz  1 , Baitun Nahar  1 , Subhasish Das  1 , Binod Shrestha  3 , Beena Koshy  4 , Estomih Mduma  5 , Jessica C Seidman  2 , Laura E Murray-Kolb  6 , Laura E Caulfield  7 , Tahmeed Ahmed  1
Affiliations

Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study

Md Ashraful Alam et al. PLoS One. .

Erratum in

Abstract

Background: Globally more than 150 million children under age 5 years were stunted in 2018, primarily in low- and middle-income countries (LMICs), and the impact of early-onset, persistent stunting has not been well explored. To explore the association between early-onset persistent stunting in children and cognitive development at 5 years of age, and to identify the factors associated with early-onset stunting.

Methods and findings: Children from the MAL-ED cohort study were followed from birth to 5 years of age in six LMICs. The Wechsler Preschool Primary Scales of Intelligence (WPPSI) was used to assess cognitive abilities (fluid reasoning) at 5 years and was adapted for each culture. Stunting was categorized as early-onset persistent (first stunted at 1-6 months and persisting at 60 months), early-onset recovered (first stunted at 1-6 months and not stunted at 60 months), late-onset persistent (first stunted at 7-24 months and persisting at 60 months), late-onset recovered (first stunted at 7-24 months and not stunted at 60 months), and never (never stunted). Mixed effects linear models were used to estimate the relationship between stunting status and cognitive development. Children with early-onset persistent stunting had significantly lower cognitive scores (-2.10 (95% CI: -3.85, -0.35)) compared with those who were never stunted. Transferrin receptor (TfR) was also negatively associated with cognitive development (-0.31 (95% CI: -0.49, -0.13)), while the HOME inventory, an index of quality of the home environment (0.46 (95% CI: 0.21, 0.72)) and socio-economic status (1.50 (95% CI: 1.03, 1.98)) were positively associated with cognitive development.

Conclusions: Early-onset persistent stunting was associated with lower cognitive development in children at 5 years of age in this cohort of children.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. MAL-ED cohort profile of children who were retained in the analysis.
[Sites: BGD: Bangladesh–Dhaka; BRF: Brazil–Fortaleza; INV: India–Vellore; NEB: Nepal–Bhaktapur; SAV: South Africa–Venda; TZH: Tanzania–Haydom].
Fig 2
Fig 2. Percent of children who had not yet experienced stunting through 2 years of age at six sites (BGD: Bangladesh—Dhaka; INV: India—Vellore; NEB: Nepal—Bhaktapur; BRF: Brazil—Fortaleza; SAV: South Africa—Venda; TZH: Tanzania—Haydom).
See this image and copyright information in PMC

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