{"doi":"10.1371/journal.pone.0227839","title":"Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study","abstract":"BACKGROUND: Globally more than 150 million children under age 5 years were stunted in 2018, primarily in low- and middle-income countries (LMICs), and the impact of early-onset, persistent stunting has not been well explored. To explore the association between early-onset persistent stunting in children and cognitive development at 5 years of age, and to identify the factors associated with early-onset stunting. METHODS AND FINDINGS: Children from the MAL-ED cohort study were followed from birth to 5 years of age in six LMICs. The Wechsler Preschool Primary Scales of Intelligence (WPPSI) was used to assess cognitive abilities (fluid reasoning) at 5 years and was adapted for each culture. Stunting was categorized as early-onset persistent (first stunted at 1-6 months and persisting at 60 months), early-onset recovered (first stunted at 1-6 months and not stunted at 60 months), late-onset persistent (first stunted at 7-24 months and persisting at 60 months), late-onset recovered (first stunted at 7-24 months and not stunted at 60 months), and never (never stunted). Mixed effects linear models were used to estimate the relationship between stunting status and cognitive development. Children with early-onset persistent stunting had significantly lower cognitive scores (-2.10 (95% CI: -3.85, -0.35)) compared with those who were never stunted. Transferrin receptor (TfR) was also negatively associated with cognitive development (-0.31 (95% CI: -0.49, -0.13)), while the HOME inventory, an index of quality of the home environment (0.46 (95% CI: 0.21, 0.72)) and socio-economic status (1.50 (95% CI: 1.03, 1.98)) were positively associated with cognitive development. CONCLUSIONS: Early-onset persistent stunting was associated with lower cognitive development in children at 5 years of age in this cohort of children.","journal":"PLoS ONE","year":2020,"id":51488,"datarank":0.7574784010874307,"base_score":5.049856007249537,"endowment":5.049856007249537,"self_citation_contribution":0.7574784010874307,"citation_network_contribution":0.0,"self_endowment_contribution":0.7574784010874307,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":155,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":260839,"name":"Stephanie A. Richard","orcid":null,"position":1,"is_corresponding":false},{"id":257476,"name":"Shah Mohammad Fahim","orcid":"0000-0002-3627-202X","position":2,"is_corresponding":false},{"id":257477,"name":"Mustafa Mahfuz","orcid":"0000-0002-4090-785X","position":3,"is_corresponding":false},{"id":257478,"name":"Baitun Nahar","orcid":"0000-0001-5285-4364","position":4,"is_corresponding":false},{"id":257479,"name":"Subhasish Das","orcid":"0000-0002-7852-6569","position":5,"is_corresponding":false},{"id":257480,"name":"Binod Shrestha","orcid":"0000-0003-2781-7742","position":6,"is_corresponding":false},{"id":257481,"name":"Beena Koshy","orcid":"0000-0002-9058-1392","position":7,"is_corresponding":false},{"id":257482,"name":"Estomih Mduma","orcid":"0000-0002-9401-3982","position":8,"is_corresponding":false},{"id":257483,"name":"Jessica C. Seidman","orcid":"0009-0005-1645-3789","position":9,"is_corresponding":false},{"id":257484,"name":"Laura E. Murray‐Kolb","orcid":"0000-0002-5836-9471","position":10,"is_corresponding":false},{"id":257485,"name":"Laura E. Caulfield","orcid":"0000-0001-7152-1004","position":11,"is_corresponding":false},{"id":52795,"name":"Tahmeed Ahmed","orcid":"0000-0002-4607-7439","position":12,"is_corresponding":false},{"id":257475,"name":"Md Ashraful Alam","orcid":"0000-0003-1389-8510","position":0,"is_corresponding":true}],"reference_count":79,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T20:41:30.009880Z","pmid":"31978156","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}