Mental Health
Home environment predicts cognitive outcomes in mid-childhood: Evidence from the MAASTHI Cohort, India Giridhara Rathnaiah Babu* Giridhara Rathnaiah Babu Babu Babu Professor of Population Medicine, College of Medicine, QU Health, Qatar University
Background
Prenatal exposures can have long‑lasting effects on neurodevelopment, yet longitudinal evidence from low‑ and middle‑income countries remains limited. We investigated whether prenatal biological and socioeconomic factors during pregnancy predict cognitive outcomes in mid‑childhood in a South Indian birth cohort.
Methods
We used data from the MAASTHI cohort, including children assessed in 2024-25 (5–9 years). The primary outcome was cognitive performance measured using Raven’s Colored Progressive Matrices. In the main analysis (n = 955 children), we examined maternal glucose, hemoglobin, birth weight, duration of breastfeeding, and household socioeconomic status. Multivariable linear regression models were adjusted for child age, mother’s age, parity, religion, and number of living children.
In a secondary complete‑case analysis (n=882 children), we additionally measured home environment characteristics measured in 2023-24 using the Family Care Indicators Tool to explore potential developmental pathways linking early exposures to later cognition.
Results
Prenatal biomarkers, birth weight, and breastfeeding duration were not associated with mid‑childhood cognitive scores, while more favourable household socioeconomic conditions during pregnancy were associated with higher cognitive scores. In the complete‑case subgroup analysis, poorer home environments were associated with low cognitive scores.
Conclusion
Early socioeconomic conditions and the quality of the home environment were key predictors of cognitive performance in mid‑childhood. These findings highlight the importance of improving socioeconomic circumstances and home environments to support optimal child neurodevelopment in low‑resource settings.
Keywords: Prenatal exposures; cognition; longitudinal cohort; socioeconomic, home environment; child development; India.