Prenatal care and child growth and schooling in four low- and medium-income countries.

<h4>Background</h4>The effectiveness of prenatal care for improving birth and subsequent child outcomes in low-income countries remains controversial, with much of the evidence to date coming from high-income countries and focused on early-life outcomes. We examined associations between...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiaoying Liu, Jere R Behrman, Aryeh D Stein, Linda S Adair, Santosh K Bhargava, Judith B Borja, Mariangela Freitas da Silveira, Bernardo L Horta, Reynaldo Martorell, Shane A Norris, Linda M Richter, Harshpal S Sachdev
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171299&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849472639786024960
author Xiaoying Liu
Jere R Behrman
Aryeh D Stein
Linda S Adair
Santosh K Bhargava
Judith B Borja
Mariangela Freitas da Silveira
Bernardo L Horta
Reynaldo Martorell
Shane A Norris
Linda M Richter
Harshpal S Sachdev
author_facet Xiaoying Liu
Jere R Behrman
Aryeh D Stein
Linda S Adair
Santosh K Bhargava
Judith B Borja
Mariangela Freitas da Silveira
Bernardo L Horta
Reynaldo Martorell
Shane A Norris
Linda M Richter
Harshpal S Sachdev
author_sort Xiaoying Liu
collection DOAJ
description <h4>Background</h4>The effectiveness of prenatal care for improving birth and subsequent child outcomes in low-income countries remains controversial, with much of the evidence to date coming from high-income countries and focused on early-life outcomes. We examined associations between prenatal care visits and birth weight, height-for-age at 24 months and attained schooling in four low- and middle-income countries.<h4>Methods</h4>We pooled data from prospective birth-cohort studies from Brazil, Guatemala, Philippines and South Africa. We created a prenatal care utilization index based on the number and timing of prenatal visits. Associations were examined between this index and birth weight, height-for-age at 24 months, and highest attained schooling grade until adulthood.<h4>Results</h4>Among 7203 individuals in the analysis, 68.9% (Philippines) to 96.7% (South Africa) had at least one prenatal care visit, with most having at least four visits. Over 40% of Brazilians and Guatemalans had their first prenatal visit in the first trimester, but fewer Filipinos (13.9%) and South Africans (19.8%) did so. Prenatal care utilization was not significantly associated with birth weight (p>0.05 in pooled data). Each unit increase in the prenatal care utilization index was associated with 0.09 (95% CI 0.04 to 0.15) higher height-for-age z-score at 24 months and with 0.26 (95% CI 0.17 to 0.35) higher schooling grades attained. Although there was some heterogeneity and greater imprecision across sites, the results were qualitatively similar among the four different populations.<h4>Conclusions</h4>While not related to birth weight, prenatal care utilization was associated with important outcomes later in life, specifically higher height-for-age at 24 months and higher attained school grades. These results suggest the relevance of prenatal care visits for human capital outcomes important over the lifecycle.
format Article
id doaj-art-33e405000e4c467fbdfd3b28f8b4989e
institution Kabale University
issn 1932-6203
language English
publishDate 2017-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-33e405000e4c467fbdfd3b28f8b4989e2025-08-20T03:24:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01122e017129910.1371/journal.pone.0171299Prenatal care and child growth and schooling in four low- and medium-income countries.Xiaoying LiuJere R BehrmanAryeh D SteinLinda S AdairSantosh K BhargavaJudith B BorjaMariangela Freitas da SilveiraBernardo L HortaReynaldo MartorellShane A NorrisLinda M RichterHarshpal S Sachdev<h4>Background</h4>The effectiveness of prenatal care for improving birth and subsequent child outcomes in low-income countries remains controversial, with much of the evidence to date coming from high-income countries and focused on early-life outcomes. We examined associations between prenatal care visits and birth weight, height-for-age at 24 months and attained schooling in four low- and middle-income countries.<h4>Methods</h4>We pooled data from prospective birth-cohort studies from Brazil, Guatemala, Philippines and South Africa. We created a prenatal care utilization index based on the number and timing of prenatal visits. Associations were examined between this index and birth weight, height-for-age at 24 months, and highest attained schooling grade until adulthood.<h4>Results</h4>Among 7203 individuals in the analysis, 68.9% (Philippines) to 96.7% (South Africa) had at least one prenatal care visit, with most having at least four visits. Over 40% of Brazilians and Guatemalans had their first prenatal visit in the first trimester, but fewer Filipinos (13.9%) and South Africans (19.8%) did so. Prenatal care utilization was not significantly associated with birth weight (p>0.05 in pooled data). Each unit increase in the prenatal care utilization index was associated with 0.09 (95% CI 0.04 to 0.15) higher height-for-age z-score at 24 months and with 0.26 (95% CI 0.17 to 0.35) higher schooling grades attained. Although there was some heterogeneity and greater imprecision across sites, the results were qualitatively similar among the four different populations.<h4>Conclusions</h4>While not related to birth weight, prenatal care utilization was associated with important outcomes later in life, specifically higher height-for-age at 24 months and higher attained school grades. These results suggest the relevance of prenatal care visits for human capital outcomes important over the lifecycle.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171299&type=printable
spellingShingle Xiaoying Liu
Jere R Behrman
Aryeh D Stein
Linda S Adair
Santosh K Bhargava
Judith B Borja
Mariangela Freitas da Silveira
Bernardo L Horta
Reynaldo Martorell
Shane A Norris
Linda M Richter
Harshpal S Sachdev
Prenatal care and child growth and schooling in four low- and medium-income countries.
PLoS ONE
title Prenatal care and child growth and schooling in four low- and medium-income countries.
title_full Prenatal care and child growth and schooling in four low- and medium-income countries.
title_fullStr Prenatal care and child growth and schooling in four low- and medium-income countries.
title_full_unstemmed Prenatal care and child growth and schooling in four low- and medium-income countries.
title_short Prenatal care and child growth and schooling in four low- and medium-income countries.
title_sort prenatal care and child growth and schooling in four low and medium income countries
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171299&type=printable
work_keys_str_mv AT xiaoyingliu prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT jererbehrman prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT aryehdstein prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT lindasadair prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT santoshkbhargava prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT judithbborja prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT mariangelafreitasdasilveira prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT bernardolhorta prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT reynaldomartorell prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT shaneanorris prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT lindamrichter prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries
AT harshpalssachdev prenatalcareandchildgrowthandschoolinginfourlowandmediumincomecountries