Growth in young Filipino children predicts schooling trajectories through high school
Growth in young Filipino children predicts schooling trajectories through high school
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DOI：
10.1093/jn/134.6.1439
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发表时间：
2004-06-01
影响因子：
4.2
通讯作者：
Adair, LS
中科院分区：
文献类型：
--
作者：
Daniels, MC;Adair, LS
几项研究将儿童营养不良与不利的学校教育结果联系起来，包括延迟或减少入学人数，以及增加年级重复率。然而，营养对就学轨迹的影响被之前大多数研究的横截面性质以及影响就学结果的一系列复杂的其他现象所掩盖。我们从宿务纵向健康和营养调查的2198名儿童中探索了2岁时的身高Z分数(HAZ)与就学轨迹之间的关系。产次、父母教育程度、母亲身高、家庭资产、环境清洁程度、电力供应和家庭收入被确定为潜在的混杂因素。对入学成绩(入学年龄、年级复读率和完成的年级)进行了粗略和调整后的Logistic回归和多项式回归。入学年龄和10岁被评估为HAZ和学业成绩之间的潜在中介变量。在对混杂因素进行调整后，随着年龄的增长，更高的身高可以防止男孩和女孩入学较晚，并预示着男孩入学较早。身高较高的儿童重读成绩的可能性较小[女孩OR=0.78(0.67，0.89)；男孩OR=0.86(0.74，0.99)]，小学辍学的可能性低于高中毕业[女孩OR=0.74(0.56，0.98)；男孩OR=0.66(0.51，0.84)]。对HAZ总体高度从-2 SD变为0 SD时，学校成绩变化的预测模型进行了模拟。迟报入学的绝对概率大幅下降，从男孩和女孩的6%下降到男孩的2%和女孩的1%。男生的绝对年级重复率下降了7%，女生的绝对重复率下降了9%。改善儿童早期营养可能会带来长期的教育效益，增加发展中国家完成高中学业的可能性。
Several studies link childhood malnutrition to adverse schooling outcomes, including delayed or diminished enrollment and increased grade repetition. However, the effects of nutrition on schooling trajectories are obscured by the cross-sectional nature of most previous research and the complex array of other phenomena that affect schooling outcomes. We explored the association between height-for-age Z-score (HAZ) at 2 y and schooling trajectory among 2198 children from the Cebu Longitudinal Health and Nutrition Survey. Parity, parental education, maternal height, household assets, environmental cleanliness, presence of electricity, and household income were identified as potential confounders. Crude and adjusted logistic and multinomial regressions of schooling outcomes (entrance age, grade repetition, and grades completed) were conducted. Entrance age and 10 were evaluated as potential mediators between HAZ and schooling outcomes. After adjustment for confounders, greater height for age protected against late enrollment among both boys and girls and predicted early enrollment among boys. Taller children were less likely to repeat grades [girls OR = 0.78 (0.67, 0.89); boys OR = 0.86 (0.74, 0.99)] and less likely to drop out during grade school rather than graduate from high school [girls OR = 0.74 (0.56, 0.98); boys OR = 0.66 (0.51, 0.84)]. Models predicting the changes in school outcomes associated with a change in overall height from -2 to 0 SD of HAZ were simulated. Absolute probability of late enrollment dropped substantially, from 6% for both boys and girls to 2% for boys and 1 % for girls. Absolute grade repetition dropped similar to7% for boys and 9% for girls. Improving early childhood nutrition may have long-lasting educational benefits, increasing the likelihood of high school completion in developing countries.