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 impact on children’s development requires further examination. This meta-analysis aims to synthesize existing research studies to clarify the relationships between childhood stunting and cognition and examine differential impacts on sub-domains of cognition. Additionally, moderating effects of this relationship are captured. We systematically reviewed literature from 1990 to 2025 in 54 languages. Thirty-six studies of the 12,191 identified, were included in our analysis. Random effect models were employed to calculate pooled effect sizes, and heterogeneity was assessed using I2 statistics. Publication bias was evaluated through Egger’s test. Our initial model revealed no effects of childhood stunting on cognitive development. Domain analyses though showed that childhood stunting was associated with poorer cognition, intelligence, executive-function, visuo-spatial and socio-emotional development in specific geographic regions. Secondary models indicated that the effects of childhood stunting were more pronounced when moderating factors such as demographics, socio-economic factors, parent-related and health-related information were controlled for. Finally, the exclusive focus on nutritional interventions limited our ability to explore the effects of other intervention types on cognitive development in children who were stunted. These findings highlight the need for further research to better understand these relationships and for the development of contextual interventions to draw robust conclusions and design targeted interventions. 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.