Affiliation:
1. Department of Pediatrics, Section of Nutrition University of Colorado School of Medicine Aurora Colorado USA
2. RTI International Durham North Carolina USA
3. Department of Psychology University of Alabama at Birmingham Birmingham Alabama USA
4. Instituto de Nutrición de Centro América y Panamá (INCAP) Guatemala City Guatemala
5. Kinshasa School of Public Health (KSPH) Kinshasa Democratic Republic of the Congo (DRC)
6. Neonatal‐Perinatal Medicine University of North Carolina Chapel Hill North Carolina USA
7. Department of Community Health Sciences Aga Khan University Karachi Pakistan
8. Department of Obstetrics and Gynecology Columbia University New York New York State USA
9. KLE Academy of Higher Education and Research (Deemed‐to‐be‐University), Jawaharlal Nehru Medical College (JNMC) Belagavi India
10. Office of Global Affairs Thomas Jefferson University Philadelphia Pennsylvania USA
11. Eunice Kennedy Shriver National Institute of Child Health and Human Development Bethesda Maryland USA
Abstract
AbstractMultiple factors influence infant and child neurodevelopment in low resource settings. In offspring of participants in the preconception maternal nutrition trial, Women First (WF), we examined the impact of providing a preconception (Arm 1) or prenatal (Arm 2) nutrient supplement (compared to controls, Arm 3) on neurodevelopmental outcomes at 24 months; predictors of neurodevelopment scores; and associations of infant anthropometrics with neurodevelopmental scores. Follow‐up visits for anthropometry were conducted at 6‐, 12‐, 18‐ and 24‐month of age. At 24‐months, in a randomized subset, the Bayley Scales of Infant Development, 3rd edition (BSID‐III), including cognitive, motor and social‐emotional subscales, and the Family Care Indicators (FCI) questionnaire, assessing family and home environment, were completed. Multiple covariates (intervention arm, site, maternal sociodemographic characteristics, FCI subscales, birthweight and 6–24 months' change in anthropometry z‐scores, (e.g., ΔLAZ6–24) were evaluated by linear regression to predict BSID‐III outcomes and to assess associations of anthropometric changes with BSID‐III scores. The analysis consisted of 1386 infants (n = 441, 486, 459 for Arms 1, 2 and 3, respectively). None of the domain‐specific BSID‐III subscale scores differed by maternal intervention arm. Four covariates significantly predicted (p ≤ 0.01) all 3 BSID‐III subscales: secondary maternal education, ΔLAZ6–24, birthweight >2500 g, and FCI play materials. Linear growth was associated with all domains of neurodevelopment. The results underscore the multi‐dimensional aspects of child development represented by the nurturing care framework, including prenatal maternal nutrition, post‐natal growth, maternal education for responsive caregiving and opportunities for early learning.
Funder
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Bill and Melinda Gates Foundation