RESUMO
Inequality between and within populations has origins in adverse early experiences. Developmental neuroscience shows how early biological and psychosocial experiences affect brain development. We previously identified inadequate cognitive stimulation, stunting, iodine deficiency, and iron-deficiency anaemia as key risks that prevent millions of young children from attaining their developmental potential. Recent research emphasises the importance of these risks, strengthens the evidence for other risk factors including intrauterine growth restriction, malaria, lead exposure, HIV infection, maternal depression, institutionalisation, and exposure to societal violence, and identifies protective factors such as breastfeeding and maternal education. Evidence on risks resulting from prenatal maternal nutrition, maternal stress, and families affected with HIV is emerging. Interventions are urgently needed to reduce children's risk exposure and to promote development in affected children. Our goal is to provide information to help the setting of priorities for early child development programmes and policies to benefit the world's poorest children and reduce persistent inequalities.
Assuntos
Desenvolvimento Infantil , HumanosRESUMO
Intra-individual variability (IIV) refers to relatively stable differences between individuals in the degree to which they show behavioral fluctuations over relatively short time periods. Using temperament as a conceptual framework the structure, stability, and biological roots of IIV were assessed over the first year of life. Biological roots were defined by maternal and infant nutrition. The sample was 249 Peruvian neonates, followed from the second trimester of pregnancy through the first 12 months of life. Maternal anthropometry, diet, iron status, and fetal growth were assessed prenatally. Neonatal anthropometry and iron status were assessed at birth. Degree of exclusive breastfeeding was assessed at 3 and 6 months, infant anthropometry was assessed at 3, 6, and 12 months, infant dietary intake was assessed at 6 and 12 months and infant iron status was tested at 12 months. Individual differences in IIV at 3, 6, and 12 months were derived from a residual standard deviation score based on infant behaviors measured using the Louisville Temperament Assessment Procedure. Principal components analysis indicated that individual differences in IIV were defined by two components at 3, 6, and 12 months. There was modest stability between IIV components assessed at 3 and 12 months. Reduced levels of IIV at 3 months were predicted by higher maternal weight and higher fetal weight gains in the first and second trimesters of pregnancy. Higher levels of IIV at 3 months were predicted by higher levels of maternal hemoglobin during pregnancy and higher levels of neonatal ferritin.
Assuntos
Individualidade , Avaliação Nutricional , Psicologia da Criança , Antropometria , Peso ao Nascer , Aleitamento Materno , Feminino , Ferritinas/metabolismo , Hemoglobinometria , Humanos , Lactente , Comportamento do Lactente , Transtornos da Nutrição do Lactente/sangue , Transtornos da Nutrição do Lactente/psicologia , Recém-Nascido , Masculino , Peru , Áreas de Pobreza , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Fatores de Risco , TemperamentoRESUMO
Poverty and associated health, nutrition, and social factors prevent at least 200 million children in developing countries from attaining their developmental potential. We review the evidence linking compromised development with modifiable biological and psychosocial risks encountered by children from birth to 5 years of age. We identify four key risk factors where the need for intervention is urgent: stunting, inadequate cognitive stimulation, iodine deficiency, and iron deficiency anaemia. The evidence is also sufficient to warrant interventions for malaria, intrauterine growth restriction, maternal depression, exposure to violence, and exposure to heavy metals. We discuss the research needed to clarify the effect of other potential risk factors on child development. The prevalence of the risk factors and their effect on development and human potential are substantial. Furthermore, risks often occur together or cumulatively, with concomitant increased adverse effects on the development of the world's poorest children.
Assuntos
Desenvolvimento Infantil , Doenças Transmissíveis/complicações , Países em Desenvolvimento , Transtornos do Crescimento/complicações , Pobreza , Carência Psicossocial , Pré-Escolar , Cognição , Retardo do Crescimento Fetal , Transtornos do Crescimento/etiologia , Humanos , Lactente , Recém-Nascido , Desnutrição , Poder Familiar , Fatores de Risco , ViolênciaRESUMO
Psychosocial influences, such as the family or the school, and biologic influences, such as nutrition or the presence of environmental toxins, can be viewed as elements of a child's overall environment. Family and school influences define dimensions of the child's psychosocial environment whereas nutrition and exposure to toxins define dimensions of the child's bioecologic environment. This paper presents a cross-generation model specifying both the nature and consequences of linkages between the psychosocial and bioecologic environments, with specific reference to schooling, nutrition, and development. Data from two studies done in Egypt and Peru are used to illustrate this model, showing how duration of breastfeeding and quality of the young child's diet are positively associated with higher levels of maternal education and intelligence.