Mechanistic Pathways From Early Gestation Through Infancy and Neurodevelopment

To identify pathways through which pre- and postnatal factors directly or indirectly affect infant neurodevelopment at 12 months of age among Filipino infants. The Bayley Scales of Infant Development, third edition was used to assess the development of 314 infants of mothers enrolled in a trial exam...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2016-12, Vol.138 (6), p.1-1
Main Authors: Park, Sangshin, Bellinger, David C, Adamo, Meredith, Bennett, Brady, Choi, Nam-Kyong, Baltazar, Palmera I, Ayaso, Edna B, Monterde, Donna Bella S, Tallo, Veronica, Olveda, Remigio M, Acosta, Luz P, Kurtis, Jonathan D, Friedman, Jennifer F
Format: Article
Language:English
Subjects:
Adult
Analysis
Causes of
Child Development
Cognition
Degeneration
Development
Developmental biology
Dietary supplements
Female
Health aspects
Humans
Infant
Infant development
Infants
Iron deficiency diseases
Longitudinal Studies
Male
Maternal & child health
Mothers
Nervous system
Neurodegenerative diseases
Neurodevelopmental Disorders - etiology
Neurosciences
Nutrition education
Nutritional Status
Pediatrics
Philippines
Pregnancy
Risk Factors
Structural equation modeling
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Summary:To identify pathways through which pre- and postnatal factors directly or indirectly affect infant neurodevelopment at 12 months of age among Filipino infants. The Bayley Scales of Infant Development, third edition was used to assess the development of 314 infants of mothers enrolled in a trial examining the safety and efficacy of praziquantel during pregnancy. Maternal covariates included socioeconomic status, iron and nutritional status, cognitive performance, and alcohol intake. Infant covariates included birth weight and feeding practices, longitudinal growth and nutritional status, hemoglobin and iron status captured at birth, and 6 and 12 months of age. Multivariable regression and structural equation modeling were used to identify significant factors associated with infant development. In regression models, maternal education, cognition, and iron status as well as infant weight-for-age z-score (WAZ), weight-for-length z-score, and WAZ gains were significantly associated with infant development at 12 months of age. Structural equation modeling demonstrated a direct effect of maternal cognition on most subscales of infant development and indirect effects on expressive language through effects on infant WAZ. Maternal iron status was a stronger predictor of infant cognition subscale scores than was infant iron status. Exclusive breastfeeding had a direct influence on expressive language rather than acting through improved infant iron or nutritional status. We identified key modifiable risk factors for impaired neurodevelopment, including prenatal risk factors such as maternal iron status. Integrated nutritional interventions that impact both maternal and infant nutritional status are likely to positively affect infant neurodevelopment through identified pathways.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2016-1843