Abstract
BackgroundGrowth faltering in early childhood is associated with poor human capital attainment, but associations of linear growth in childhood with executive and socioemotional functioning in adulthood are understudied. ObjectivesIn a Guatemalan cohort, we identified distinct trajectories of linear growth in early childhood, assessed their predictors, and examined associations between growth trajectories and neurodevelopmental outcomes in adulthood. We also assessed the mediating role of schooling on the association of growth trajectories with adult cognitive outcomes. MethodsIn 2017–2019, we prospectively followed 1499 Guatemalan adults who participated in a food supplementation trial in early childhood (1969–1977). We derived height-for-age sex-specific growth trajectories from birth to 84 mo using latent class growth analysis. ResultsWe identified 3 growth trajectories (low, intermediate, high) with parallel slopes and intercepts already differentiated at birth in both sexes. Children of taller mothers were more likely to belong to the high and intermediate trajectories [relative risk ratio (RRR): 1.21; 95% CI: 1.15, 1.26, and RRR: 1.11; 95% CI: 1.07, 1.15, per 1-cm increase in height, respectively] compared with the low trajectory. Children in the wealthiest compared with the poorest socioeconomic tertile were more likely to belong to the high trajectory compared with the low trajectory (RRR: 2.24; 95% CI: 1.29, 3.88). In males, membership in the high compared with low trajectory was positively associated with nonverbal fluid intelligence, working memory, inhibitory control, and cognitive flexibility at ages 40–57 y. Sex-adjusted results showed that membership in the high compared with low trajectory was positively associated with meaning and purpose scores at ages 40–57 y. Associations of intermediate compared with low growth trajectories with study outcomes were also positive but of lesser magnitude. Schooling partially mediated the associations between high and intermediate growth trajectories and measures of cognitive ability in adulthood. ConclusionsModifiable and nonmodifiable risk factors predicted growth throughout childhood. Membership in the high and intermediate growth trajectories was positively associated with adult cognitive and socioemotional functioning.
Highlights
The period from conception to 2 y is crucial for neurobehavioral development, providing the foundation for lifelong health and well-being [1]
Mediation analyses Mediation analysis showed that the indirect effect through schooling corresponded to 51% of the total effect of high height-for-age z scores (HAZs) trajectory on nonverbal fluid intelligence, 42% of the total effect of high HAZ trajectory on working memory, and 51% of the total effect of high HAZ trajectory on inhibitory control
Similar associations were observed between intermediate HAZ trajectory and nonverbal fluid intelligence, working
Summary
The period from conception to 2 y is crucial for neurobehavioral development (i.e., sensory–motor, cognitive–language, and social–emotional function), providing the foundation for lifelong health and well-being [1]. Associations of linear growth in early childhood with socioemotional outcomes in adulthood are understudied. Studies have used height-for-age z scores (HAZs) measured at 1 time point (or at most a limited number of time points) to examine associations of linear growth in childhood with. Objectives: In a Guatemalan cohort, we identified distinct trajectories of linear growth in early childhood, assessed their predictors, and examined associations between growth trajectories and neurodevelopmental outcomes in adulthood. Sex-adjusted results showed that membership in the high compared with low trajectory was positively associated with meaning and purpose scores at ages 40–57 y. Schooling partially mediated the associations between high and intermediate growth trajectories and measures of cognitive ability in adulthood. Membership in the high and intermediate growth trajectories was positively associated with adult cognitive and socioemotional functioning.
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