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Cognitive Deficit and Poverty in the First 5 Years of Childhood in Bangladesh
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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“By contrast, longitudinal studies in Bangladesh, Costa Rica, and Jamaica all reported that infant and toddler home stimulation quality predicted IQ or global development in preschool or middle childhood (Grantham-McGregor et al. 1991;Lozoff et al. 1995;Hamadani, Tofail, and Huda 2014;Walker et al. 2000).”
From Early Family Experiences and Neural Activity in Rural Pakistani Children: The Differential Role of Gender (2024) · cites this paper as Hamadani, Tofail, and Huda 2014
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“Prior research in LMIC contexts shows that the association of home stimulation quality with cognitive outcomes only becomes evident around age 5 (Hamadani, Tofail, and Huda 2014;Lozoff et al. 1995;Walker et al. 2000)”
From Early Family Experiences and Neural Activity in Rural Pakistani Children: The Differential Role of Gender (2024) · cites this paper as Hamadani, Tofail, and Huda 2014
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Metadata
- 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
- 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
- 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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