Document Detail

Living on higher ground reduces child neurodevelopment-evidence from South America.
MedLine Citation:
PMID:  23092532     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the effects of altitude on infant neurodevelopment in the first 2 years of life.
STUDY DESIGN: Data from a unique study of normal infant neurodevelopment in 5 South American countries were used. The sample included 2116 infants 3-24 months of age who were evaluated for neurodevelopmental problems by study physicians during their routine well-child visits at 31 pediatric practices. We used regression models with country fixed-effects that compare the neurodevelopment of children born at different altitudes within the same country to avoid confounding. The regressions adjust for several socioeconomic and demographic factors. We also evaluated altitude effects stratifying by sex, age, and household wealth. Infant neurodevelopment was evaluated by physicians by using the Bayley Infant Neurodevelopmental Screener. The primary outcome is an indicator for whether the infant is at high risk for neurodevelopmental problems based on the Bayley Infant Neurodevelopmental Screener norms.
RESULTS: Altitude significantly increases the probability of being at high risk for neurodevelopmental problems (100-meter increase in altitude: OR 1.02; 95% CI 1.001-1.037; high altitude greater than 2600 meters vs low altitude less than 800 meters: OR 2.01; 95% CI 1.36-2.973). The effects are larger for females and for second than first year of life. The largest effect is for females 12-24 months of age (high vs low altitude: OR 4.147; 95% CI 1.466-12.013). There are no significant differences in altitude effects by household wealth.
CONCLUSIONS: Altitude may significantly increase the risk of neurodevelopmental problems during the first 2 years of life, especially for females during their second year of life.
George L Wehby
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-23
Journal Detail:
Title:  The Journal of pediatrics     Volume:  162     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-26     Completed Date:  2013-04-26     Revised Date:  2014-03-09    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  606-611.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
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MeSH Terms
Child Development*
Child, Preschool
Cross-Sectional Studies
Mass Screening / methods*
Nervous System / growth & development*
Nervous System Diseases / diagnosis*
Risk Factors
South America
Grant Support

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