Christopher T Andersen

Bio: Christopher T Andersen is an academic researcher from Harvard University. The author has contributed to research in topics: Population & Medicine. The author has an hindex of 6, co-authored 15 publications receiving 1177 citations. Previous affiliations of Christopher T Andersen include University of California, Berkeley & World Bank Group.

No global consensus: a cross-sectional survey of maternal weight policies

Abstract: Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines. This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known. These results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child.

Participation in the Juntos Conditional Cash Transfer Program in Peru Is Associated with Changes in Child Anthropometric Status but Not Language Development or School Achievement

Abstract: Background: It is unclear what effects a conditional cash transfer (CCT) program would have on child anthropometry, language development, or school achievement in the context of the nutrition transition experienced by many low- and middle-income countries. Objective: We estimated the association of participation in Perus Juntos CCT with anthropometry, language development, and school achievement among children aged 7–8 y. Methods: We used data from the Young Lives cohort study, a cohort born between 2001 and 2002. We estimated associations of the Juntos program with height-for-age z score (HAZ), body mass index–for–age z score (BAZ), stunting, and overweight at age 7–8 y separately for children participating in the program for $ 2y( n = 169) and children participating for <2 y (n = 188). We then estimated associationswithreceptivevocabularyand gradeachievementamongchildrenwhohadbeenassessedatage4–6ybeforeenrollmentin Juntos (n = 243). We identified control subjects using propensity score matching and conducted difference-in-differences comparisons. Results: Juntos participation was associated with increases in HAZ among boys participating for $2 y [average effect of treatment among the treated (ATT): 0.43; 95% CI: 0.09, 0.77;P = 0.01] and for boys participating for <2 y (ATT: 0.52; 95% CI: 0.23, 0.80; P < 0.01). Among girls participating in the program for $2 y, BAZ declined (ATT: –0.60; 95% CI: –1.00, –0.21; P < 0.01) as did the prevalence of overweight (ATT: –22.0 percentage points; 95% CI: –42.5, –2.7 percentage points; P = 0.03). We observed no significant associations of Juntos participation with receptive vocabulary or grade attainment. Conclusions: CCT program participation in Peru was associated with better linear growth among boys and decreased BAZ among girls, highlighting that a large-scale poverty-alleviation intervention may influence anthropometric outcomes in the context of the nutrition transition. J Nutr doi: 10.3945/jn.115.213546.

Disparities in children's vocabulary and height in relation to household wealth and parental schooling: A longitudinal study in four low- and middle-income countries.

Abstract: Children from low socio-economic status (SES) households often demonstrate worse growth and developmental outcomes than wealthier children, in part because poor children face a broader range of risk factors. It is difficult to characterize the trajectories of SES disparities in low- and middle-income countries because longitudinal data are infrequently available. We analyze measures of children's linear growth (height) at ages 1, 5, 8 and 12y and receptive language (Peabody Picture Vocabulary Test) at ages 5, 8 and 12y in Ethiopia, India, Peru and Vietnam in relation to household SES, measured by parental schooling or household assets. We calculate children's percentile ranks within the distributions of height-for-age z-scores and of age- and language-standardized receptive vocabulary scores. We find that children in the top quartile of household SES are taller and have better language performance than children in the bottom quartile; differences in vocabulary scores between children with high and low SES are larger than differences in the height measure. For height, disparities in SES are present by age 1y and persist as children age. For vocabulary, SES disparities also emerge early in life, but patterns are not consistent across age; for example, SES disparities are constant over time in India, widen between 5 and 12y in Ethiopia, and narrow in this age range in Vietnam and Peru. Household characteristics (such as mother's height, age, and ethnicity), and community fixed effects explain most of the disparities in height and around half of the disparities in vocabulary. We also find evidence that SES disparities in height and language development may not be fixed over time, suggesting opportunities for policy and programs to address these gaps early in life.

Benefits of Early Childhood Interventions Across the World: (Under) Investing in the Very Young

Abstract: Milagros Nores, Assistant Research Professor, National Institute for Early Education Research, Rutgers, the State University of New Jersey (NJ, United States). Email: mnores@nieer.org Address: 57 US Highway 1, New Brunswick, NJ 08901-8554, United States.W. Steven Barnett, Board of Governors Professor and Director of the National Institute for Early Education Research, Rutgers, the State University of New Jersey (NJ, United States). Email: wbarnet@rci.rutgers.edu Address: 57 US Highway 1, New Brunswick, NJ 08901-8554, United States.This paper uses a meta-analysis to review the evidence on the benefits of early childhood interventions. The authors also analyze how the revealed effects are correlated with characteristics of the corrective measures and with the target audience.A total of 38 contrasts of 30 interventions in 23 countries were analyzed. The paper focuses on studies applying a quasi-experimental or random assignment. Studies were coded according to: the type of intervention (cash transfer, nutritional, educational or mixed); sample size; study design and duration; country; target group (infants, prekindergarten); subpopulations of interventions; and dosage of intervention. Cohen’s D effect sizes were calculated for four outcomes: cognitive gains; behavioral change; health gains; and amount of schooling.A moderate progress has been revealed in each of the outcomes. The benefits are sustained over time. Interventions that have an educational or mixed (educational and stimulation, or care) component evidenced the largest cognitive effects, as compared to cash infusions or nutrition-specific interventions. We find children from different context and countries receive substantial cognitive, behavioral, health and schooling benefits from early childhood interventions, unlike children whose development is not supported or promoted. Direct care and education appear to be the most efficient interventions, especially for development of cognitive skills in early childhood.DOI: 10.17323/1814-9545-2012-1-200-228