Childhood stunting and cognitive development: a meta-analysis

Childhood stunting is associated with delayed developmental trajectories. While the relationship between childhood stunting and cognitive development has been widely studied, the results remain inconsistent. This meta-analysis aims to synthesize existing research to clarity if there is any relationship and then examine in which cognitive sub-domains it lies. Additionally, it will attempt to capture moderating effects of this relationship as well as examine the intervention evidence. We systematically reviewed literature from 1990 to 2023. Thirty-four studies, of the 2164 identified, were included in our analysis. Random effect models were employed to calculate pooled effect sizes, and heterogeneinty was assessed using I2 statistics. Publication bias was evaluated through Egger’s test. Our models revelaed that childhood stunting was associated with poor cognition, intelligence, motor-skills, executive-function,visuo-spatial and socio-emotional development in specific regions (e.g., Asia). Sub-group analyses indicated that effects were more pronounced when controlled for moderating factors such as demographics and health-related information. Finally, nutritional interventions did not affect cognitive development in stunted children. These findings highlight the critical need for further research to better understand this relationships. Future research should explore standardised culturally sensitive assessments tools, emphasising the necessity of accurate reporting, and the exploration of moderating effects across cognitive sub-domains.