Cited by 157Child Nutrition and Water AccessPoverty, Education, and Child WelfareInfant Development and Preterm Care

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

Hamadani, Jena D., Tofail, Fahmida, Huda, Syed N., Alam, Dewan S., Ridout, Deborah A., Attanasio, Orazio, Grantham-McGregor, Sally M.·2014·Pediatrics

DOI 10.1542/peds.2014-0694

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Abstract

OBJECTIVE: We aimed to determine the timing and size of the cognitive deficit associated with poverty in the first 5 years of life and to examine the role of parental characteristics, pre- and postnatal growth, and stimulation in the home in Bangladeshi children. We hypothesized that the effect of poverty on cognition begins in infancy and is mainly mediated by these factors. METHODS: We enrolled 2853 singletons, a subsample from a pregnancy supplementation trial in a poor rural area. We assessed mental development at 7, 18, and 64 months; anthropometry at birth, 12, 24, and 64 months; home stimulation at 18 and 64 months; and family’s socioeconomic background. In multiple regression analyses, we examined the effect of poverty at birth on IQ at 64 months and the extent that other factors mediated the effect. RESULTS: A mean cognitive deficit of 0.2 (95% confidence interval –0.4 to –0.02) z scores between the first and fifth wealth quintiles was apparent at 7 months and increased to 1.2 (95% confidence interval –1.3 to –1.0) z scores of IQ by 64 months. Parental education, pre- and postnatal growth in length, and home stimulation mediated 86% of the effects of poverty on IQ and had independent effects. Growth in the first 2 years had larger effects than later growth. Home stimulation had effects throughout the period. CONCLUSIONS: Effects of poverty on children’s cognition are mostly mediated through parental education, birth size, growth in the first 24 months, and home stimulation in the first 5 years.

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Authors: Hamadani, J. D., Tofail, F., Huda, S. N., Alam, D. S., Ridout, D. A., Attanasio, O., & Grantham-McGregor, S. M.
Affiliations: International Centre for Diarrhoeal Disease Research (BD)
University of Dhaka (BD)
Centre for Paediatric Epidemiology and Biostatistics,
University College London (GB)
Centre for International Health and Development, Institute of Child Health, and
ORCID: Hamadani, Jena D.
Tofail, Fahmida
Huda, Syed N.
Alam, Dewan S.
Ridout, Deborah A.
Attanasio, Orazio
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2014-10-01
Volume: 134
Issue: 4
Pages: e1001-e1008
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2014-0694
OpenAlex: W2002215450
Cited by: 155
References: 28
Citations by year: 2026: 3 · 2025: 13 · 2024: 18 · 2023: 12 · 2022: 15 · 2021: 15 · 2020: 23 · 2019: 17 · 2018: 9 · 2017: 15 · 2016: 9 · 2015: 5 · 2014: 1
FWCI: 9.31
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Funders: Economic and Social Research Council (ES/H021221/1, ES/K010700/1)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Social Sciences › Development › Poverty, Education, and Child Welfare
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords: poverty, cognitive impairment, early childhood, IQ, parental education, fetal growth, postnatal growth, home stimulation, socioeconomic status, mediation, Bangladesh, rural children
MeSH terms: Adult, Anthropometry, Bangladesh, Child Development, Child, Preschool, Cognition Disorders, Female, Follow-Up Studies, Humans, Infant, Longitudinal Studies, Male, Poverty, Pregnancy, Socioeconomic Factors, Cohort Studies, Young Adult

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

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