Condition category
Not Applicable
Date applied
02/10/2017
Date assigned
05/10/2017
Last edited
05/10/2017
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims
Early life growth faltering (slower than expected rate of growth) has increasingly been recognized as a risk factor for children’s long run developmental and economic potential. While several studies have linked adult outcomes to child growth at the individual level, there is a lack of evidence on the long run benefits of reducing stunting rates at the national or subnational (population) levels. The aim of this study is to estimate the associations between early life growth faltering at the subnational (population) level and adult height and education outcomes in a representative sample of low- and middle-income countries.

Who can participate?
Adults born between 1985 and 1995 across 34 Demographic and Health Surveys (DHS) conducted between 2006 and 2014 in 24 low- and middle-income countries

What does the study involve?
Data from the DHS surveys is used to calculated average height-for-age for children under age 5 at the country-region and birth cohort level (a group of people born during a particular period or year). The measures of early life growth are then compared with adult height and educational attainment.

What are the possible benefits and risks of participating?
This study only uses de-identified data from the DHS Program and there is no further data collection.

Where is the study run from?
ICF International (USA)

When is the study starting and how long is it expected to run for?
April 2017 to September 2017

Who is funding the study?
Boston University (USA)

Who is the main contact?
Prof. Mahesh Karra

Trial website

Contact information

Type

Scientific

Primary contact

Prof Mahesh Karra

ORCID ID

http://orcid.org/0000-0003-0962-092X

Contact details

152 Bay State Road
Room G04C
Boston
02215
United States of America

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

IRB16-0515

Study information

Scientific title

Long run effects of early life growth faltering: a retrospective analysis of 847 birth cohorts in low- and middle-income countries

Acronym

Study hypothesis

To estimate the associations between exposure to early life growth faltering at the subnational (population) level and adult height and education outcomes in a representative sample of low- and middle-income countries.

Ethics approval

This study obtained a human subjects exemption from the institutional review board at Harvard University, 05/04/2016, protocol number IRB16-0515. Only de-identified data were obtained from the Demographic and Health (DHS) survey program at https://dhsprogram.com/

Study design

Observational cross-sectional cohort study

Primary study design

Observational

Secondary study design

Cross sectional study

Trial setting

Other

Trial type

Other

Patient information sheet

Not available in web format, please use the contact details to request a patient information sheet

Condition

Early life growth faltering (height and stunting at childhood)

Intervention

All available anthropometric data collected through the Demographic and Health Surveys (DHS) is combined to construct country-region measures of early childhood exposure to growth faltering, and this dataset is used to quantify the long-term outcomes of cohort-level changes in early life environments. The final analytic sample consists of 211,318 adult records across 34 DHS surveys that were conducted between 2006 and 2014 in 24 low- and middle-income countries.

Data from the Demographic and Health Surveys were used to compute average height-for-age z-scores for children under age 5 at the country-region and birth cohort level. The cohort measures of early life growth were then linked to adult height and educational attainment. The primary exposure of interest was population-level early life growth faltering, with adult height and adult educational attainment as primary outcomes. Multivariable linear regression models were used to estimate the associations between adult outcomes and population-level measures of early life linear growth.

Intervention type

Other

Phase

Drug names

Primary outcome measures

1. Adult height, measured by reported height in adulthood, taken from DHS surveys conducted between 2006 and 2014
2. Educational attainment, measured by the highest educational grade completed, taken from DHS surveys conducted between 2006 and 2014

Secondary outcome measures

No secondary outcome measures

Overall trial start date

18/04/2017

Overall trial end date

28/09/2017

Reason abandoned

Eligibility

Participant inclusion criteria

211,318 adults who born between 1985 and 1995 across 34 DHS surveys that were conducted between 2006 and 2014 in 24 low- and middle-income countries

Participant type

Mixed

Age group

Adult

Gender

Both

Target number of participants

211,318

Participant exclusion criteria

Missing income data

Recruitment start date

01/01/1985

Recruitment end date

31/12/1995

Locations

Countries of recruitment

Burkina Faso, Cameroon, Colombia, Cote d'Ivoire, Dominican Republic, Egypt, Ghana, Haiti, Jordan, Kenya, Madagascar, Malawi, Mali, Nepal, Niger, Nigeria, Pakistan, Peru, Rwanda, Senegal, Tanzania, Uganda, Zambia, Zimbabwe

Trial participating centre

ICF International
530 Gaither Road, Suite 500
Rockville
20850
United States of America

Sponsor information

Organisation

Boston University

Sponsor details

121 Bay State Road
Boston
02215
United States of America

Sponsor type

University/education

Website

Funders

Funder type

University/education

Funder name

Boston University

Alternative name(s)

BU

Funding Body Type

private sector organisation

Funding Body Subtype

academic

Location

United States of America

Results and Publications

Publication and dissemination plan

The trialists intend to submit the results of the study for publication to the American Journal of Clinical Nutrition.

IPD sharing statement
The trialists only used de-identified data from the DHS Program and were in no way involved with any of the data collection or human subjects processes. Further information about participation in a DHS survey can be found here: https://dhsprogram.com/What-We-Do/Protecting-the-Privacy-of-DHS-Survey-Respondents.cfm. The DHS data are publicly available at https://dhsprogram.com/ - the data can be accessed free of charge upon request from ICF International, the organization that manages the DHS data.

Intention to publish date

31/12/2017

Participant level data

Available on request

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes