Early-Life Stature, Preschool Cognitive Development, Schooling Attainment, and Cognitive Functioning in Adulthood: A Prospective Study in Four Birth Cohorts

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Citation

Stein, Aryeh D.; Adair, Linda S.; Donati, Georgina; Wray, Charlotte; Richter, Linda M.; Norris, Shane A.; Stein, Alan; Martorell, Reynaldo; Ramirez-Zea, Manuel; & Menezes, Ana M. B., et al. (2023). Early-Life Stature, Preschool Cognitive Development, Schooling Attainment, and Cognitive Functioning in Adulthood: A Prospective Study in Four Birth Cohorts. Lancet Global Health, 11(1), e95-104. PMCID: PMC9764453

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.

URL

http://dx.doi.org/10.1016/s2214-109x(22)00448-x

Reference Type

Journal Article

Year Published

2023

Journal Title

Lancet Global Health

Author(s)

Stein, Aryeh D.
Adair, Linda S.
Donati, Georgina
Wray, Charlotte
Richter, Linda M.
Norris, Shane A.
Stein, Alan
Martorell, Reynaldo
Ramirez-Zea, Manuel
Menezes, Ana M. B.
Murray, Joseph
Victora, Cesar G.
Lee, Nanette R.
Bas, Isabelita N.

Article Type

Regular

PMCID

PMC9764453

Data Set/Study

Consortium of Health-Oriented Research in Transitioning Societies (COHORTS)

Continent/Country

Brazil
Guatemala
South Africa
Philippines

ORCiD

Adair - 0000-0002-3670-8073