Weight gain in the first two years of life is an important predictor of schooling outcomes in pooled analyses from five birth cohorts from low- and middle-income countries.
Schooling predicts better reproductive outcomes, better long-term health, and increased lifetime earnings. We used data from 5 cohorts (Brazil, Guatemala, India, the Philippines, and South Africa) to explore the relative importance of birthweight and postnatal weight gain for schooling in pooled analyses (n = 7945) that used appropriate statistical methods [conditional weight (CW) gain measures that are uncorrelated with prior weights] and controlled for confounding. One SD increase in birthweight, approximately 0.5 kg, was associated with 0.21 y more schooling and 8% decreased risk of grade failure. One SD increase in CW gain between 0 and 2 y, approximately 0.7 kg, was associated with higher estimates, 0.43 y more schooling, and 12% decreased risk of failure. One SD increase of CW gain between 2 and 4 y, approximately 0.9 kg, was associated with only 0.07 y more schooling but not with failure. Also, in children born in the lowest tertile of birthweight, 1 SD increase of CW between 0 and 2 y was associated with 0.52 y more schooling compared with 0.30 y in those in the upper tertile. Relationships with age at school entry were inconsistent. In conclusion, weight gain during the first 2 y of life had the strongest associations with schooling followed by birthweight; weight gain between 2 and 4 y had little relationship to schooling. Catch-up growth in smaller babies benefited schooling. Nutrition interventions aimed at women and children under 2 y are among the key strategies for achieving the millennium development goal of universal primary education by 2015.
Martorell
Reynaldo
R
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. rmart77@emory.edu
Horta
Bernardo L
BL
Adair
Linda S
LS
Stein
Aryeh D
AD
Richter
Linda
L
Fall
Caroline H D
CH
Bhargava
Santosh K
SK
Biswas
S K Dey
SK
Perez
Lorna
L
Barros
Fernando C
FC
Victora
Cesar G
CG
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001724:Birth Weight; D015331:Cohort Studies; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D007223:Infant; D008297:Male; D009035:Mothers; D016017:Odds Ratio; D012574:Schools; D015430:Weight Gain; D055815:Young Adult