Weight Gain in the First Two Years of Life Is an Important Predictor of Schooling Outcomes in Pooled Analyses from Five Birth Cohorts from Low- and Middle-Income Countries

Abstract

Schooling predicts better reproductive outcomes, better long-term health, and increased lifetime earnings. We used data from 5 cohorts (Brazil, Guatemala, India, the Philippines, and South Africa) to explore the relative importance of birthweight and postnatal weight gain for schooling in pooled analyses (n = 7945) that used appropriate statistical methods [conditional weight (CW) gain measures that are uncorrelated with prior weights] and controlled for confounding. One SD increase in birthweight, ∼0.5 kg, was associated with 0.21 y more schooling and 8% decreased risk of grade failure. One SD increase in CW gain between 0 and 2 y, ∼0.7 kg, was associated with higher estimates, 0.43 y more schooling, and 12% decreased risk of failure. One SD increase of CW gain between 2 and 4 y, ∼0.9 kg, was associated with only 0.07 y more schooling but not with failure. Also, in children born in the lowest tertile of birthweight, 1 SD increase of CW between 0 and 2 y was associated with 0.52 y more schooling compared with 0.30 y in those in the upper tertile. Relationships with age at school entry were inconsistent. In conclusion, weight gain during the first 2 y of life had the strongest associations with schooling followed by birthweight; weight gain between 2 and 4 y had little relationship to schooling. Catch-up growth in smaller babies benefited schooling. Nutrition interventions aimed at women and children under 2 y are among the key strategies for achieving the millennium development goal of universal primary education by 2015.

Cognitive Deficit and Poverty in the First 5 Years of Childhood in Bangladesh

“…The index has been described previously 23 and was divided into quintiles, with the first being the poorest. We used the method described previously 10 to calculate growth in length and weight from birth to 12, 12 to 24, and 24 to 64 months independent of previous measures. We regressed the measure at the older for each interval on the previous measure, then used the standardized residuals.…”

“…We included a quadratic term in the regressions to account for nonlinear relationships. 10 Birth length and weight were expressed in SD scores for this sample.…”

“…Several longitudinal studies have shown growth failure in the first 2 years is related to later cognition 9 and schooling. 10,11 However, an important risk factor, stimulation in the home, was not taken into account. There are few longitudinal studies in LMICs tracing the development of cognitive deficits associated with poverty through the first 5 years that have examined the role of pre-and postnatal growth and home stimulation, as well as parental education.…”

The politics of reducing malnutrition: building commitment and accelerating progress

“…The studies in Guatemala of the long-term benefi ts of undernutrition prevention 41,42 have been extremely infl uential worldwide, and the Consortium on Health Orientated Research in Transitional Societies (COHORTS) group is starting to yield multicountry evidence about the long-term implications of early childhood nutrition. 43,44 The challenge is to generate contemporary political payoff s to these nutritionally driven long-term labour-market benefi ts. The demo graphic transition that many developing countries are experiencing and debating at the highest policy circles presents an example of one such opportunity to communicate the importance of nutrition in ways that resonate.…”

Velocidade de ganho de peso nos primeiros anos de vida e excesso de peso entre 5-11 anos de idade, Salvador, Bahia, Brasil

“…Além do que, sabe-se que crianças com ganho de peso lento estão em risco de consequências adversas tais como a baixa estatura, problemas de comportamento e atraso no desenvolvimento 10 . Recentemente, em um estudo que reuniu informações de cinco diferentes coortes foram observadas evidências de que a recuperação do crescimento ponderal em crianças nascidas com baixo peso aumentou as chances de a criança frequentar a escola anos mais tarde 11 .…”