Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Mohakhali, Bangladesh.
Child Care Health Dev. 2024 Jan;50(1):e13225. doi: 10.1111/cch.13225.
Children's development is multifactorial. Although there have been several studies exploring the association of children's development with maternal, child, and environmental factors, we are unaware of any study that assessed those factors in children whose mothers were enrolled in a social safety net programme in low- and middle-income countries. This study aimed to identify the factors associated with disadvantaged children's cognitive, language, and motor development at age 6-16 months in deprived settings of urban Bangladesh and to identify relative importance of these factors of children's development. We also explored if there were any gender differences in child development.
This cross-sectional study was conducted in a deprived setting of urban Bangladesh. Bayley III was used for assessing children's cognitive, language, and motor development. Multivariable linear regression model was used to find the factors associated with children's development, and dominance analysis was used to explore the relative importance of the factors.
Out of the total 599 mother-child dyads, 303 (50.58%) were girls. The factors associated with children's development were length-for-age Z-score (cognitive: B = 1.21 [95% CI = 0.31, 2.11], P = 0.008; language: 1.67 [0.79, 2.55] P < 0.001; motor: 2.15 [1.01, 3.29] P < 0.001) and home environment (cognitive: 0.58 [0.27, 0.89] P < 0.001; language: 0.59 [0.27, 0.92], P < 0.001; motor: 0.44 [0.09, 0.79] P = 0.013). Girls had higher cognitive (1.90 [0.17, 3.6], P = 0.031) and language (2.53 [0.55, 4.51], P = 0.013) development compared with boys. Families with a higher number of under five children within the households had lower language (-1.57 [-2.78, -0.36], P = 0.011) development. Violence against the mother and the families' food security status were not associated with the children's development. Children's length-for-age Z-score (27%) and home stimulation environment (23%) were the most important factors of cognitive development.
Children's nutritional status and home environment are important factors for disadvantaged children's development in deprived urban settings of Bangladesh. Both early child development-focussed parenting and nutrition interventions should be considered when designing child development programmes in urban settings in low- and middle-income countries.
儿童的发展是多因素的。尽管已有多项研究探讨了儿童发展与母亲、儿童和环境因素之间的关系，但我们并不清楚在中低收入国家参加社会安全网计划的母亲所生的儿童中，是否有任何研究评估了这些因素。本研究旨在确定孟加拉国城市贫困地区 6-16 个月大的儿童在认知、语言和运动发育方面处于不利地位的相关因素，并确定这些儿童发育因素的相对重要性。我们还探讨了儿童发育是否存在性别差异。
这是一项在孟加拉国城市贫困地区进行的横断面研究。采用贝利婴幼儿发展量表第三版评估儿童的认知、语言和运动发育。使用多变量线性回归模型来确定与儿童发育相关的因素，并使用优势分析来探索这些因素的相对重要性。
在总共 599 对母婴中，303 名（50.58%）为女孩。与儿童发育相关的因素包括年龄别身长 Z 评分（认知：B=1.21[95%CI=0.31,2.11]，P=0.008；语言：1.67[0.79,2.55]，P<0.001；运动：2.15[1.01,3.29]，P<0.001）和家庭环境（认知：0.58[0.27,0.89]，P<0.001；语言：0.59[0.27,0.92]，P<0.001；运动：0.44[0.09,0.79]，P=0.013）。与男孩相比，女孩的认知（1.90[0.17,3.6]，P=0.031）和语言（2.53[0.55,4.51]，P=0.013）发育更高。家庭中五岁以下儿童数量较多的家庭，语言发育较差（-1.57[-2.78,-0.36]，P=0.011）。针对母亲的暴力和家庭粮食安全状况与儿童发育无关。儿童的年龄别身长 Z 评分（27%）和家庭刺激环境（23%）是认知发育最重要的因素。
在孟加拉国城市贫困地区，儿童的营养状况和家庭环境是儿童发展的重要因素。在设计中低收入国家城市环境中的儿童发展方案时，应考虑早期儿童发展为重点的养育和营养干预措施。
