Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows

Objective To illustrate that a mediation framework can help integrate inferences from three growth models to enable a comprehensive view of the associations between growth during specific developmental windows and mid-childhood IQ.Design We analysed direct and indirect associations between mid-child...

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Main Authors: Diego G Bassani, Michael Leung, Aditi Krishna, Seungmi Yang, Daniel E Roth
Format: Article
Language:English
Published: BMJ Publishing Group 2020-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/8/e036850.full
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author Diego G Bassani
Michael Leung
Aditi Krishna
Seungmi Yang
Daniel E Roth
author_facet Diego G Bassani
Michael Leung
Aditi Krishna
Seungmi Yang
Daniel E Roth
author_sort Diego G Bassani
collection DOAJ
description Objective To illustrate that a mediation framework can help integrate inferences from three growth models to enable a comprehensive view of the associations between growth during specific developmental windows and mid-childhood IQ.Design We analysed direct and indirect associations between mid-childhood IQ and length/height growth in five early-life age intervals bounded by conception, birth, early, mid and late infancy, and mid-childhood using estimates from three growth models (lifecourse, conditional change and change score) applied to three historical birth cohorts.Participants and setting 12 088 term-born children from the Collaborative Perinatal Project (CPP) in the USA (n=2170), the Promotion of Breastfeeding Intervention Trial (PROBIT) in Belarus (n=8275) and the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines (n=1643).Primary outcome measure Mid-childhood IQ.Results Our analyses revealed cross-cohort and cross-interval variations in the direct and indirect effects of foetal and early childhood physical growth on mid-childhood IQ. For example, in CPP, there was a direct association of prenatal growth with IQ that was not evident in the other cohorts, whereas in PROBIT and CLHNS, we observed that foetal and early growth-IQ associations were mediated through size in later periods.Conclusion Lifecourse, conditional change and change score growth models yield complementary inferences when appropriately interpreted. Future longitudinal studies of associations of early-life growth with later outcomes would benefit from adopting a causal mediation framework to integrate inferences from multiple complementary growth models.
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spelling doaj-art-3e8ab86341ca4960bdca073dab51bb302025-08-20T02:51:23ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2020-036850Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windowsDiego G Bassani0Michael Leung1Aditi Krishna2Seungmi Yang3Daniel E Roth4Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, CanadaObstetrics and Gynecology, Kelsey-Seybold Clinic, Houston, Texas, USACentre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada2 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, CanadaDepartment of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, CanadaObjective To illustrate that a mediation framework can help integrate inferences from three growth models to enable a comprehensive view of the associations between growth during specific developmental windows and mid-childhood IQ.Design We analysed direct and indirect associations between mid-childhood IQ and length/height growth in five early-life age intervals bounded by conception, birth, early, mid and late infancy, and mid-childhood using estimates from three growth models (lifecourse, conditional change and change score) applied to three historical birth cohorts.Participants and setting 12 088 term-born children from the Collaborative Perinatal Project (CPP) in the USA (n=2170), the Promotion of Breastfeeding Intervention Trial (PROBIT) in Belarus (n=8275) and the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines (n=1643).Primary outcome measure Mid-childhood IQ.Results Our analyses revealed cross-cohort and cross-interval variations in the direct and indirect effects of foetal and early childhood physical growth on mid-childhood IQ. For example, in CPP, there was a direct association of prenatal growth with IQ that was not evident in the other cohorts, whereas in PROBIT and CLHNS, we observed that foetal and early growth-IQ associations were mediated through size in later periods.Conclusion Lifecourse, conditional change and change score growth models yield complementary inferences when appropriately interpreted. Future longitudinal studies of associations of early-life growth with later outcomes would benefit from adopting a causal mediation framework to integrate inferences from multiple complementary growth models.https://bmjopen.bmj.com/content/10/8/e036850.full
spellingShingle Diego G Bassani
Michael Leung
Aditi Krishna
Seungmi Yang
Daniel E Roth
Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows
BMJ Open
title Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows
title_full Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows
title_fullStr Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows
title_full_unstemmed Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows
title_short Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows
title_sort linear growth and mid childhood cognitive outcomes in three birth cohorts of term born children an approach to integrating three growth models to explore critical windows
url https://bmjopen.bmj.com/content/10/8/e036850.full
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