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Abstract
The relationship of cognitive developmental trajectories during the dynamic first years with later life development outcomes remains unclear in low- and middle-income countries. 1388 Children born to women who participated in a randomized trial of antenatal micronutrient supplementation in rural China were prospectively followed. Cognitive development was assessed six times between 3 and 30 months of age using Bayley Scales of Infant Development, and then in mid-childhood (7–9 years) and early adolescence (10–12 years) using Wechsler Intelligence Scale for Children. We identified four distinct infant cognitive development trajectory subgroups using group-based trajectory modeling: (i) consistently above average, (ii) consistently average, (iii) started below average and then improved, and (iv) started below average and then declined. LBW infants (<2500 g) were 10.60 times (95% CI 3.57, 31.49) more likely to be in the trajectory group that started below average and then declined, while each grade increase in maternal education decreased the risk of being in this group by 73% (95% CI 54%, 84%). Infants who performed consistently above average had 8.02 (95% CI 1.46, 14.59) points higher IQ in adolescence versus the declining trajectory group. These findings suggest that interventions to improve early child development trajectories may produce long-term human capital benefits.
Highlights
An estimated 250 million children under five years living in low- and middle- income countries (LMICs) failed to reach their full developmental potential[1]
A total of 669 and 735 of these participants were followed at middle childhood (7–9 years) and early adolescence (10–12 years), respectively (Supplementary Fig. S1)
Most background characteristics were similar between individuals who completed the middle childhood and early adolescence assessments and those who were lost to follow-up (Supplementary Table S1)
Summary
An estimated 250 million children under five years living in low- and middle- income countries (LMICs) failed to reach their full developmental potential[1]. A limitation of studies that examined early life determinants of cognitive development typically only assess children at a single time-point, which does not capture the dynamic process of child development. Only a few studies from high-income countries focused on preterm infants have assessed cognitive development trajectories in early childhood. Factors Child characteristics Male Birth weight (g) Weeks of gestation at birth Preterm (
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