Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica.
Lancet. 2011 Oct 8;378(9799):1325-38. doi: 10.1016/S0140-6736(11)60555-2. Epub 2011 Sep 22.
Inequality between and within populations has origins in adverse early experiences. Developmental neuroscience shows how early biological and psychosocial experiences affect brain development. We previously identified inadequate cognitive stimulation, stunting, iodine deficiency, and iron-deficiency anaemia as key risks that prevent millions of young children from attaining their developmental potential. Recent research emphasises the importance of these risks, strengthens the evidence for other risk factors including intrauterine growth restriction, malaria, lead exposure, HIV infection, maternal depression, institutionalisation, and exposure to societal violence, and identifies protective factors such as breastfeeding and maternal education. Evidence on risks resulting from prenatal maternal nutrition, maternal stress, and families affected with HIV is emerging. Interventions are urgently needed to reduce children's risk exposure and to promote development in affected children. Our goal is to provide information to help the setting of priorities for early child development programmes and policies to benefit the world's poorest children and reduce persistent inequalities.
人群之间和人群内部的不平等现象源于不利的早期经历。发展神经科学展示了早期的生物和社会心理经历如何影响大脑发育。我们之前已经确定，认知刺激不足、发育迟缓、碘缺乏和缺铁性贫血是阻止数以百万计的幼儿发挥其发展潜力的关键风险因素。最近的研究强调了这些风险的重要性，为包括宫内生长受限、疟疾、铅暴露、艾滋病毒感染、产妇抑郁、机构化以及社会暴力暴露在内的其他风险因素提供了更有力的证据，并确定了诸如母乳喂养和母亲教育等保护因素。关于产前母亲营养、母亲压力以及受艾滋病毒影响的家庭所导致风险的证据正在出现。迫切需要采取干预措施，减少儿童面临的风险，并促进受影响儿童的发展。我们的目标是提供信息，帮助确定早期儿童发展方案和政策的优先事项，造福世界上最贫困的儿童，并减少持续存在的不平等现象。
