Editorial
Social and biological determinants of growth and development in underprivileged societies
Determinantes sociais e biológicos do crescimento e desenvolvimento em sociedades menos favorecidas
Mijna Hadders-Algra
Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
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(in this issue)<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> addresses the role of social and biological factors in growth and development of young children in a disadvantaged society. The authors assessed a group of 92 children, aged 24–36 months, who in 2011 attended the municipal early childhood education network in a town in the Vale do Jequitinhonha region. This region in the southeast of Brazil is considered economically underprivileged. The study was restricted to children with typical development, which meant that the children did not suffer from an evident congenital or acquired disability. Growth was assessed by means of standard anthropometrics, with a focus on height-for-age, a valid tool to assess childhood malnutrition.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> Development was measured with the Bayley Scales of Infant and Toddler Development (BSITD-III),<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> the gold standard to measure developmental outcome at early age. The cognitive score and the expressive language scores were used as outcome parameters. Biological risk was assessed by a few perinatal factors, such as gestational age at birth, birth weight, pregnancy complications, and the number of prenatal consultations, and a few childhood parameters, including breastfeeding, the presence of chronic diseases, infectious diseases, and hospital admissions. The social environment was documented extensively, not only by means of parental level of education, the number of siblings, and the number of people in the household, but also with standardized questionnaires to assess (a) the economic situation (with the questionnaire of the Brazilian Association of Research Companies [Associação Brasileira de Empresas de Pesquisa]); (b) the quality of early childhood education (with the Infant/Toddler Environment Rating Scale – Revised); (c) the quality of the home environment (with the Home Observation for Measurement of the Environment (HOME) Inventory); and (d) the quality of the neighborhood (with a self-developed questionnaire including questions on accessibility and quality of services).</p><p id="par0010" class="elsevierStylePara elsevierViewall">The results confirmed that the children had a socially disadvantaged background. This was reflected by the finding that about 90% of the fathers had not completed high school, and that approximately half of the children did not live with both parents. The large majority of children were born at term (94%), without signs of severe intrauterine growth restriction. Almost half of the children had had chronic and/or infectious diseases in the three months preceding the study.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Impaired growth, defined as height-for-age falling below two standard deviations of the norm, occurred in 15% of children. Multivariable analysis indicated that stunted growth was associated with birth weight and the number of prenatal consultations. None of the many social factors contributed to impaired growth. This suggests that early childhood growth is largely determined by the quality of prenatal life. The child's prenatal condition, in turn, is based on a complex interaction of biological and social factors, in which psychological and physiological stress during pregnancy, including infections and inadequate nutrition, play a role.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> High levels of psychosocial stress are not only associated with a lower birthweight, but also with a lower number of antenatal consultations.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Interestingly, the study by da Rocha Neves et al.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> reported that none of the children were thin, whereas overweight occurred in 4.4% of children. Nowadays, not only is impaired growth related to disadvantaged social conditions; overweight is also associated with low parental education, large household size, and lower socioeconomic status.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> In addition, increasing evidence suggests that both impaired growth in early life and childhood overweight put the child at increased risk for cardiovascular disease in adulthood.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Almost 30% of the children had a cognitive impairment or language impairment – impairments defined as scores falling one standard deviation below the mean. In contrast to stunted growth, cognitive and language development were not associated with biological risk factors, but only with social ones. Cognitive development was associated with the HOME score; language development was associated with the HOME score and the quality of the neighborhood in terms of infrastructure, and interaction and trust. The data suggest that childhood cognitive and language development in disadvantaged communities are strongly dependent on environmental conditions, implying that improvement of these environmental conditions may promote child development. Indeed, the review of Komro et al.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a> indicated that strategies that aim at the enhancement of social cohesion and improvement of the physical environment are associated with better cognitive development and child health. However, whether specific early intervention programs that aim to teach parents how they best can stimulate their child's development – programs that are effective in infants at biological risk for cognitive impairment<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> – are also effective in promoting cognitive development in children from socially disadvantaged families is not clear.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Does the absence of a contribution of biological factors to impaired cognitive outcome imply that biological factors do not play a role in developmental outcome of children in underprivileged societies? Presumably, that is not the correct conclusion. In the first place, da Rocha Neves et al. assessed only a few prenatal, perinatal, and neonatal factors. For instance, no data were available on maternal prepregnancy weight, maternal diseases, and maternal smoking during pregnancy, as well as perinatal asphyxia. These factors are known to have an adverse effect on long-term developmental outcome.<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">11,12</span></a> For example, term born infants prenatally exposed to maternal smoking on average have a 10-point reduction of their intelligence quotient (IQ) compared to peers who have not be exposed to maternal smoking prenatally.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a> Secondly, developmental outcome focused on cognitive and language development, and the outcome of the psychomotor developmental index of the BSITD-III was not reported. It is conceivable that motor development at 2–3 years of age did depend on early biological factors, such as birth weight and gestational age. Animal experiments<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> and early intervention studies<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> both indicate that motor development is more hardwired in the brain than cognitive development, implying that the former is more strongly determined by biology than the latter. Thirdly, da Rocha Neves et al. assessed developmental outcome at 2–3 years. At that age, only a part of cognitive functions have been developed. With increasing age and with increasing complexity of the nervous system, new cognitive functions develop. It is first with the appearance of a function that the impairment of that function can be diagnosed. This is the reason that most cognitive impairments and cognitive and behavioral disorders first emerge at school age.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> It is conceivable that with increasing age, the contribution of early biological and social factors on cognitive outcome changes. At early age – as da Rocha Neves et al. reported – the influence of social factors may dominate. But it may be surmised that at school age the impact of early biological factors increases, in line with the developmental origin of health and disease hypothesis.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">16,17</span></a> Increasing evidence suggests that prenatal and perinatal adversities may have a long lasting effect on development and heath.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">16,18</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The study by da Rocha Neves et al. draws the attention to the need for improved antenatal and early childhood care in order to facilitate child health and development. The first step to be taken is to improve prenatal care, in which an adequate number of antenatal consultations plays a pivotal role. Not only is a low number of antenatal visits associated with stunted growth – as the study by da Rocha Neves et al. demonstrated – it is also a well-known risk factor of neonatal mortality and morbidity.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a> The World Health Organization (WHO) recommends at least four antenatal care visits, with the initial visit occurring during the first trimester, the second between 24 and 28 weeks of gestation, and the third and fourth at 32 and 36 weeks of gestation, respectively.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a> Factors that prevent women from receiving an adequate number of pregnancy consultations include poverty, lack of information, the distance to the antenatal care service, inadequate services, and cultural practices.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> This means that the biology of early life is largely determined by socio-economic conditions. Not only prenatal care should be targeted to improve child growth and development; postnatal rearing conditions also have a strong impact on child development. As the study by da Rocha Neves et al. demonstrated, the child's cognitive development is largely dependent on the home environment, including the quality of caregiving, parental responsivity, and the presence of learning material.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The outcome of the study by da Rocha Neves et al. stresses the need for long-term follow-up of infants who grow up in economically disadvantaged situations. Only in this way will we understand how the complex interaction of biological and social adversities during early life impacts growth, health – including cardiovascular disease and obesity – and developmental outcome, including cognitive impairments and psychiatric morbidity. Only in this way will we know which type of social and health services during pregnancy and during childhood are needed to achieve optimal child health and development.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The author declares no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Hadders-Algra M. Social and biological determinants of growth and development in underprivileged societies. J Pediatr (Rio J). 2016;92:217–9.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">See paper by da Rocha Neves et al. in pages 241–50.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Growth and development and their environmental and biological determinants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. da Rocha Neves" 1 => "R.L. de Souza Morais" 2 => "R.A. Teixeira" 3 => "P.A. Pinto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Pediatr (Rio J)" "fecha" => "2016" "volumen" => "92" "paginaInicial" => "241" "paginaFinal" => "250" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0110" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Time trends in socio-economic inequalities in stunting prevalence: analyses of repeated national surveys" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.C. Restrepo-Méndez" 1 => "A.J. Barros" 2 => "R.E. Black" 3 => "C.G. Victora" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/S1368980014002924" "Revista" => array:6 [ "tituloSerie" => "Public Health Nutr" "fecha" => "2015" "volumen" => "18" "paginaInicial" => "2097" "paginaFinal" => "2104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25521530" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0115" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bayley Scales of Infant and Toddler Development: technical manual" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "N. Bayley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "3rd ed." "fecha" => "2006" "editorial" => "Harcourt Assessment" "editorialLocalizacion" => "San Antonio" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0120" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Support during pregnancy for women at increased risk of low birthweight babies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.D. Hodnett" 1 => "S. Fredericks" 2 => "J. Weston" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2010" "paginaInicial" => "CD000198" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0125" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.J. Brown" 1 => "J.S. Yelland" 2 => "G.A. Sutherland" 3 => "P.A. Baghurst" 4 => "J.S. Robinson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2458-11-196" "Revista" => array:5 [ "tituloSerie" => "BMC Public Health" "fecha" => "2011" "volumen" => "11" "paginaInicial" => "196" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21450106" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0130" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Keino" 1 => "G. Plasqui" 2 => "G. Ettyang" 3 => "B. van den Borne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Food Nutr Bull" "fecha" => "2014" "volumen" => "35" "paginaInicial" => "167" "paginaFinal" => "178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25076764" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0135" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coronary heart disease: a disorder of growth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.M. Robinson" 1 => "D.J. Barker" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Proc Nutr Soc" "fecha" => "2002" "volumen" => "61" "paginaInicial" => "537" "paginaFinal" => "542" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12691183" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0140" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beyond the clinic: improving child health through evidence-based community development" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K.A. Komro" 1 => "A.L. Tobler" 2 => "A.L. Delisle" 3 => "R.J. O’Mara" 4 => "A.C. Wagenaar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2431-13-172" "Revista" => array:5 [ "tituloSerie" => "BMC Pediatr" "fecha" => "2013" "volumen" => "13" "paginaInicial" => "172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24138839" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0145" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Spittle" 1 => "J. Orton" 2 => "P.J. Anderson" 3 => "R. Boyd" 4 => "L.W. Doyle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/14651858.CD005495.pub4" "Revista" => array:5 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2015" "volumen" => "11" "paginaInicial" => "CD005495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26597166" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0150" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Home-based child development interventions for preschool children from socially disadvantaged families" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Miller" 1 => "L.K. Maguire" 2 => "G. Macdonald" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2011" "paginaInicial" => "CD008131" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0155" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perinatal and early postnatal factors underlying developmental delay and disabilities" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Z. Ergaz" 1 => "A. Ornoy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ddrr.1101" "Revista" => array:6 [ "tituloSerie" => "Dev Disabil Res Rev" "fecha" => "2011" "volumen" => "17" "paginaInicial" => "59" "paginaFinal" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23362026" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0160" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The interaction of malnutrition and neurologic disability in Africa" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Kerac" 1 => "D.G. Postels" 2 => "M. Mallewa" 3 => "A. Alusine Jalloh" 4 => "W.P. Voskuijl" 5 => "N. Groce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.spen.2014.01.003" "Revista" => array:6 [ "tituloSerie" => "Semin Pediatr Neurol" "fecha" => "2014" "volumen" => "21" "paginaInicial" => "42" "paginaFinal" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24655404" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0165" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of long-chain polyunsaturated fatty acid supplementation of infant formula on cognition and behaviour at 9 years of age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. de Jong" 1 => "H.K. Kikkert" 2 => "V. Fidler" 3 => "M. Hadders-Algra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1469-8749.2012.04444.x" "Revista" => array:6 [ "tituloSerie" => "Dev Med Child Neurol" "fecha" => "2012" "volumen" => "54" "paginaInicial" => "1102" "paginaFinal" => "1108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23066842" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0170" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brain plasticity and recovery from early cortical injury" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Kolb" 1 => "R. Mychasiuk" 2 => "P. Williams" 3 => "R. Gibb" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1469-8749.2011.04054.x" "Revista" => array:6 [ "tituloSerie" => "Dev Med Child Neurol" "fecha" => "2011" "volumen" => "53" "paginaInicial" => "4" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21950386" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0175" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "General movements: a window for early identification of children at high risk for developmental disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Hadders-Algra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "2004" "volumen" => "145" "paginaInicial" => "S12" "paginaFinal" => "S18" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15292882" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0180" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early life origins of psychological development and mental health" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Räikkönen" 1 => "A.K. Pesonen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1467-9450.2009.00786.x" "Revista" => array:6 [ "tituloSerie" => "Scand J Psychol" "fecha" => "2009" "volumen" => "50" "paginaInicial" => "583" "paginaFinal" => "591" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19930257" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0185" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two distinct forms of minor neurological dysfunction: perspectives emerging from a review of data of the Groningen Perinatal Project" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Hadders-Algra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dev Med Child Neurol" "fecha" => "2002" "volumen" => "44" "paginaInicial" => "561" "paginaFinal" => "571" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12206624" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0190" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Motor and cognitive outcomes in nondisabled low-birth-weight adolescents: early determinants" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.H. Whitaker" 1 => "J.F. Feldman" 2 => "J.M. Lorenz" 3 => "S. Shen" 4 => "F. McNicholas" 5 => "M. Nieto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archpedi.160.10.1040" "Revista" => array:6 [ "tituloSerie" => "Arch Pediatr Adolesc Med" "fecha" => "2006" "volumen" => "160" "paginaInicial" => "1040" "paginaFinal" => "1046" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17018463" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0195" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health system and community level interventions for improving antenatal care coverage and health outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Mbuagbaw" 1 => "N. Medley" 2 => "A.J. Darzi" 3 => "M. Richardson" 4 => "K. Habiba Garga" 5 => "P. Ongolo-Zogo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/14651858.CD010994.pub2" "Revista" => array:5 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2015" "volumen" => "12" "paginaInicial" => "CD010994" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26621223" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0200" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "World Health Organization (WHO). Maternal mortality. Factsheet 348. Available from: <a id="intr0010" class="elsevierStyleInterRef" href="http://www.who.int/mediacentre/factsheets/fs348/en/">http://www.who.int/mediacentre/factsheets/fs348/en/</a> [accessed 13.12.15]." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00217557/0000009200000003/v1_201605260119/S002175571600036X/v1_201605260119/en/main.assets" "Apartado" => array:4 [ "identificador" => "10177" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00217557/0000009200000003/v1_201605260119/S002175571600036X/v1_201605260119/en/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002175571600036X?idApp=UINPBA000049" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 20 | 4 | 24 |
| 2024 October | 51 | 19 | 70 |
| 2024 September | 43 | 26 | 69 |
| 2024 August | 69 | 35 | 104 |
| 2024 July | 49 | 37 | 86 |
| 2024 June | 33 | 22 | 55 |
| 2024 May | 31 | 16 | 47 |
| 2024 April | 50 | 21 | 71 |
| 2024 March | 46 | 16 | 62 |
| 2024 February | 34 | 25 | 59 |
| 2024 January | 29 | 22 | 51 |
| 2023 December | 21 | 25 | 46 |
| 2023 November | 17 | 30 | 47 |
| 2023 October | 25 | 34 | 59 |
| 2023 September | 25 | 36 | 61 |
| 2023 August | 15 | 15 | 30 |
| 2023 July | 13 | 10 | 23 |
| 2023 June | 20 | 9 | 29 |
| 2023 May | 28 | 14 | 42 |
| 2023 April | 21 | 11 | 32 |
| 2023 March | 34 | 31 | 65 |
| 2023 February | 19 | 22 | 41 |
| 2023 January | 18 | 15 | 33 |
| 2022 December | 35 | 17 | 52 |
| 2022 November | 26 | 18 | 44 |
| 2022 October | 36 | 23 | 59 |
| 2022 September | 20 | 30 | 50 |
| 2022 August | 23 | 22 | 45 |
| 2022 July | 16 | 27 | 43 |
| 2022 June | 25 | 24 | 49 |
| 2022 May | 20 | 32 | 52 |
| 2022 April | 26 | 41 | 67 |
| 2022 March | 30 | 28 | 58 |
| 2022 February | 18 | 20 | 38 |
| 2022 January | 13 | 34 | 47 |
| 2021 December | 17 | 20 | 37 |
| 2021 November | 10 | 16 | 26 |
| 2021 October | 12 | 20 | 32 |
| 2021 September | 7 | 7 | 14 |
| 2021 August | 5 | 4 | 9 |
| 2021 July | 5 | 9 | 14 |
| 2021 June | 7 | 1 | 8 |
| 2021 May | 13 | 10 | 23 |
| 2021 April | 12 | 8 | 20 |
| 2021 March | 15 | 6 | 21 |
| 2021 February | 8 | 13 | 21 |
| 2021 January | 9 | 18 | 27 |
| 2020 December | 7 | 5 | 12 |
| 2020 November | 8 | 13 | 21 |
| 2020 October | 6 | 12 | 18 |
| 2020 September | 12 | 13 | 25 |
| 2020 August | 7 | 3 | 10 |
| 2020 July | 10 | 6 | 16 |
| 2020 June | 7 | 5 | 12 |
| 2020 May | 10 | 4 | 14 |
| 2020 April | 12 | 7 | 19 |
| 2020 March | 6 | 4 | 10 |
| 2020 February | 21 | 6 | 27 |
| 2020 January | 12 | 16 | 28 |
| 2019 December | 10 | 5 | 15 |
| 2019 November | 4 | 2 | 6 |
| 2019 October | 6 | 9 | 15 |
| 2019 September | 7 | 7 | 14 |
| 2019 August | 7 | 8 | 15 |
| 2019 July | 17 | 6 | 23 |
| 2019 June | 7 | 9 | 16 |
| 2019 May | 12 | 8 | 20 |
| 2019 April | 17 | 13 | 30 |
| 2019 March | 7 | 5 | 12 |
| 2019 February | 5 | 4 | 9 |
| 2019 January | 6 | 6 | 12 |
| 2018 December | 9 | 8 | 17 |
| 2018 November | 13 | 3 | 16 |
| 2018 October | 83 | 17 | 100 |
| 2018 September | 8 | 5 | 13 |
| 2018 August | 9 | 4 | 13 |
| 2018 July | 7 | 3 | 10 |
| 2018 June | 5 | 3 | 8 |
| 2018 May | 10 | 12 | 22 |
| 2018 April | 5 | 1 | 6 |
| 2018 March | 5 | 5 | 10 |
| 2018 February | 2 | 1 | 3 |
| 2018 January | 7 | 2 | 9 |
| 2017 December | 0 | 2 | 2 |
| 2017 November | 6 | 2 | 8 |
| 2017 October | 9 | 3 | 12 |
| 2017 September | 8 | 2 | 10 |
| 2017 August | 4 | 2 | 6 |
| 2017 July | 2 | 1 | 3 |
| 2017 June | 5 | 0 | 5 |
| 2017 May | 2 | 2 | 4 |
| 2017 April | 5 | 2 | 7 |
| 2017 March | 2 | 0 | 2 |
| 2017 February | 5 | 0 | 5 |
| 2017 January | 7 | 1 | 8 |
| 2016 December | 6 | 1 | 7 |
| 2016 November | 4 | 6 | 10 |
| 2016 October | 13 | 12 | 25 |
| 2016 September | 9 | 3 | 12 |
| 2016 August | 22 | 2 | 24 |
| 2016 July | 49 | 24 | 73 |
| 2016 June | 46 | 19 | 65 |
| 2016 May | 14 | 10 | 24 |
| 2016 April | 12 | 9 | 21 |
| 2016 March | 7 | 4 | 11 |
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