Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA.
Department of Epidemiology, Emory University, Atlanta, GA.
J Pediatr. 2024 Dec;275:114202. doi: 10.1016/j.jpeds.2024.114202. Epub 2024 Jul 19.
To evaluate in a rural Tanzanian birth cohort the association between birth timing in relation to the preharvest lean season and early-life growth and cognitive development.
Children were enrolled within 14 days of birth and followed up for 18 months. Child anthropometry was measured every 3 months. The Malawi Developmental Assessment Test was administered at the end of follow-up. We estimated the association between timing of birth in the context of other early childhood risk factors and both growth and Malawi Developmental Assessment Test scores.
Children born in the preharvest months September and October had the lowest cognitive scores at 18 months, compared with birth in July and August (-1.05 change in overall Malawi Developmental Assessment Test development-for-age Z score, 95% CI: -1.23, -0.86). This association was observed for the language (-1.67 change in development-for-age Z score; 95% CI: -1.93, -1.40) and fine motor subcomponent scores (-1.67; 95% CI: -1.96, -1.38) but not for gross motor (-0.07; 95% CI: -0.23, 0.10) or social subcomponents (-0.07; 95% CI: -0.23, 0.10). Children born in September and October were the longest at birth but had the largest declines in growth Z scores during the first 6 months.
There was a strong association between birth at the beginning of the preharvest season and poor growth and cognitive development. If these associations were mediated by the preharvest postnatal environment, targeted maternal and child interventions for children born during high-risk periods may improve these outcomes.
NCT03268902 (https://clinicaltrials.gov/study/NCT03268902).
在坦桑尼亚农村的一个出生队列中评估与收获前瘦季相关的出生时间与生命早期生长和认知发育之间的关系。
儿童在出生后 14 天内入组，并随访 18 个月。每 3 个月测量一次儿童的人体测量指标。在随访结束时进行马拉维发展评估测试。我们估计了在其他儿童早期风险因素的背景下，出生时间与生长和马拉维发展评估测试评分之间的关系。
与 7 月和 8 月出生相比，9 月和 10 月出生的儿童在 18 个月时的认知评分最低（整体马拉维发展评估测试发育年龄 Z 评分变化-1.05，95%CI：-1.23，-0.86）。这种关联在语言（发育年龄 Z 评分变化-1.67；95%CI：-1.93，-1.40）和精细运动子成分评分中观察到（-1.67；95%CI：-1.96，-1.38），但在粗大运动（-0.07；95%CI：-0.23，0.10）或社会子成分中未观察到（-0.07；95%CI：-0.23，0.10）。9 月和 10 月出生的儿童出生时最长，但在头 6 个月内生长 Z 评分下降最大。
收获前季节开始时出生与生长和认知发育不良之间存在很强的关联。如果这些关联是由收获前产后环境介导的，那么针对高危期出生的儿童进行有针对性的母婴干预措施可能会改善这些结果。
NCT03268902（https://clinicaltrials.gov/study/NCT03268902）。
