How consistent are associations between maternal and paternal education and child growth and development outcomes across 39 low-income and middle-income countries?
How consistent are associations between maternal and paternal education and child growth and development outcomes across 39 low-income and middle-income countries?
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DOI：
10.1136/jech-2017-210102
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发表时间：
2018-05-01
影响因子：
6.3
通讯作者：
Subramanian, S. V.
中科院分区：
文献类型：
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作者：
Jeong, Joshua;Kim, Rockli;Subramanian, S. V.
母亲和父亲的教育与改善早期儿童的结果有关。然而，鲜为人知的是，这些相对协会比较学龄前儿童的成长与发展成果，并across country contextuals.Methods我们分析了39个低收入和中等收入国家（LMICs）的89663名36至59个月的儿童的数据。我们使用线性回归模型和国家固定效应来估计母亲和父亲的教育与儿童的生长和发育结果之间的联合关联。此外，我们研究了每个国家和国家亚组之间这些关系的变异性。（95% CI 0.33 - 0.41）和0.20（95% CI 0.16 - 0.24）年龄别身高z评分较高，和0.31（95% CI 0.29至0.34）和0.16（95% CI 0.14至0.18）分别高出幼儿发展指数z评分（比较中学或更高教育与未受教育）。与父亲教育程度相比，母亲教育程度的关联更强，但在儿童结局之间具有可比性。在针对具体国家的回归分析中，我们发现母亲教育与儿童成长之间的关联以及父亲教育与儿童发展之间的关联最具异质性。亚组分析表明，这些协会可能是系统的国家级成人文盲，婴儿死亡率和粮食security.Conclusion模式，我们的研究结果突出的变化，照顾者的教育和儿童的结果之间的关联的统计意义和幅度。需要进一步研究，以了解可能促进或限制照顾者教育对低收入国家儿童早期健康和发展的好处的变化来源。
Background Maternal and paternal education are associated with improved early child outcomes. However, less is known about how these relative associations compare for preschool children's growth versus development outcomes; and across country contexts.Methods We analysed data from 89663 children aged 36 to 59 months in 39 low-income and middle-income countries (LMICs). We used linear regression models with country fixed effects to estimate the joint associations between maternal and paternal education and children's growth and development outcomes. Additionally, we examined the variability in these relationships by each country and within subgroups of countries.Results In the pooled sample, maternal and paternal education were independently associated with 0.37 (95% CI 0.33 to 0.41) and 0.20 (95% CI 0.16 to 0.24) higher height-for-age z-scores, and 0.31 (95% CI 0.29 to 0.34) and 0.16 (95% CI 0.14 to 0.18) higher Early Childhood Development Index z-scores, respectively (comparing secondary or higher to no education). Associations were stronger for maternal education than paternal education but comparable between child outcomes. In country-specific regressions, we found the most heterogeneity in the associations between maternal education and children's growth; and between paternal education and children's development. Subgroup analyses suggested that these associations may be systematically patterned by country-level adult illiteracy, infant mortality and food insecurity.Conclusion Our findings highlight variability in the statistical significance and magnitude of the associations between caregivers' education and children's outcomes. Further research is needed to understand the sources of variation that may promote or constrain the benefits of caregivers' education for children's early health and development in LMICs.