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...
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171299&type=printable |
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| 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) |
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| 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 |
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