Effects of Maternal Worm Infections and Anthelminthic Treatment during Pregnancy on Infant Motor and Neurocognitive Functioning

Nampijja, Margaret; Apule, Barbara; Lule, Swaib A.; Akurut, Hellen; Muhangi, Lawrence; Webb, Emily L.; Lewis, C. S.; Elliott, Alison M.; Alcock, Katie

doi:10.1017/s1355617712000768

Cited by 35 publications

(35 citation statements)

References 71 publications

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“…This finding suggests that from birth to 18 months, children's growth in height is generally related to the development of language, motor, and personal-social skills (feeding, dressing, and toilet training) but not executive function or socioemotional skills (paying attention, regulating anger and aggression). This lack of association is consistent with 1 study that found no association between child height and scores on the A-not-B task in 15-monthold children in Uganda 23 and 1 study that found no association with attention in 6-to 9-month-old infants. 28 Few studies examining linear growth in children aged <2 years have assessed socioemotional or executive function, partly because these factors are difficult to assess at this age.…”

Section: Tablesupporting

confidence: 85%

Linear Growth and Child Development in Burkina Faso, Ghana, and Malawi

Prado¹,

Abbeddou²,

Adu‐Afarwuah

et al. 2016

Pediatrics

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We aimed to produce quantitative estimates of the associations between 4 domains of child development and linear growth during 3 periods: before birth, early infancy, and later infancy. We also aimed to determine whether several factors attenuated these associations. METHODS:In 3700 children in Burkina Faso, Ghana, and Malawi, growth was measured several times from birth to age 18 months. At 18 months, language, motor, socioemotional, and executive function development were assessed. In Burkina Faso (n = 1111), personalsocial development was assessed rather than the latter 2 domains. RESULTS:Linear growth was significantly associated with language, motor, and personalsocial development but not socioemotional development or executive function. For language, the pooled adjusted estimate of the association with length-for-age z score (LAZ) at 6 months was 0.13 ± 0.02 SD, and with ΔLAZ from 6 to 18 months it was 0.11 ± 0.03 SD. For motor, these estimates were 0.16 ± 0.02 SD and 0.22 ± 0.03 SD, respectively. In 1412 children measured at birth, estimates of the association with LAZ at birth were similar (0.07-0.16 SD for language and 0.09-0.18 SD for motor development). These associations were weaker or absent in certain subsets of children with high levels of developmental stimulation or mothers who received nutritional supplementation. CONCLUSIONS:Growth faltering during any period from before birth to 18 months is associated with poor development of language and motor skills. Interventions to provide developmental stimulation or maternal supplementation may protect children who are faltering in growth from poor language and motor development.

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Section: Tablesupporting

confidence: 85%

Linear Growth and Child Development in Burkina Faso, Ghana, and Malawi

Prado¹,

Abbeddou²,

Adu‐Afarwuah

et al. 2016

Pediatrics

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“…The exercise is repeated ten times. Children not completing all ten tests were excluded from analyses. Self‐control task , which assesses impulsivity. The child is required to watch as a treat is promised to them, but they have to wait for two minutes to take it.…”

Section: Methodsmentioning

confidence: 99%

Early child development in children who are HIV‐exposed uninfected compared to children who are HIV‐unexposed: observational sub‐study of a cluster‐randomized trial in rural Zimbabwe

et al. 2020

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Introduction Exposure to maternal HIV may affect early child development (ECD), although previous studies have reported heterogeneous findings. We evaluated ECD among children who were HIV‐exposed uninfected (CHEU) and children who were HIV‐unexposed (CHU) recruited to the SHINE trial in rural Zimbabwe. Methods SHINE was a community‐based cluster‐randomized trial of improved infant feeding and/or improved water, sanitation and hygiene. Pregnant women were enrolled between 2012 and 2015. We assessed ECD in a sub‐study at 24 months of age, between 2016 and 2017, using the Malawi Developmental Assessment Tool (MDAT; assessing motor, cognitive, language and social development); MacArthur‐Bates Communicative Development Inventory (CDI) (assessing vocabulary and grammar); A‐not‐B test (assessing object permanence); and a self‐control task. Mothers and infants were tested longitudinally for HIV. We used generalized estimating equations to compare ECD scores between CHEU and CHU, accounting for the cluster‐randomized design. Primary results were adjusted for trial‐related factors that could affect measurement reliability of ECD: study nurse, age of child, calendar month of birth, sex and randomized arm. Results A total of 205 CHEU and 1175 CHU were evaluated. Mean total MDAT score was 90.6 (SD 8.7) in CHEU compared to 92.4 (9.1) in CHU (adjusted mean difference −1.3, 95% CI: −2.3, −0.3), driven mostly by differences in gross motor (−0.5, 95% CI: −0.9, −0.2) and language scores (−0.6, 95% CI: −1.1, −0.1). There was evidence that fine motor scores were lower in CHEU (adjusted mean difference −0.4, 95% CI: −0.8, 0.0) but no evidence of a difference in social scores (0.1, 95% CI: −0.2, 0.4). Mean MacArthur‐Bates CDI vocabulary score was 57.9 (SD 19.2) in CHEU compared to 61.3 (18.8) in CHU (adjusted mean difference −2.9 words, 95% CI: −5.7, −0.1). Object permanence and self‐control scores were similar between groups. Conclusions CHEU in rural Zimbabwe had total child development and vocabulary scores that were approximately 0.15 standard deviations lower than CHU at two years of age. More detailed and specific studies are now needed to unravel the reasons for developmental delay in CHEU and the likelihood that these delays persist in the longer term.

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“…We assessed executive function with the use of a version of the A-not-B task, which is a widely used test of working memory and executive function in very young children that previously has been used successfully in Kenya and Uganda (24)(25)(26). In each of 10 trials, a small piece of a cracker was hidden under one of 2 identical cups on a wooden board.…”

Section: Developmental Assessment Measuresmentioning

confidence: 99%

Effects of maternal and child lipid-based nutrient supplements on infant development: a randomized trial in Malawi

Prado

Maleta

Ashorn

et al. 2016

The American Journal of Clinical Nutrition

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Background: Maternal and infant undernutrition is associated with poor infant development; however, few studies have examined the impact of combined pre-and postnatal dietary supplementation on infant development. Objective: Our objective was to determine whether provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) to mothers during pregnancy and the first 6 mo postpartum, and to children aged 6-18 mo, improves infant development in Malawi. Design: We randomly assigned 869 pregnant women to receive one of the following daily: an iron and folic acid (IFA) capsule, a multiple micronutrient (MMN) capsule containing 18 micronutrients, or a 20-g sachet of SQ-LNSs containing 22 vitamins and minerals, protein, carbohydrates, essential fatty acids, and 118 kcal. Children in the lipid-based nutrient supplement (LNS) group only received SQ-LNSs from 6 to 18 mo of age. We monitored the acquisition of 11 developmental milestones monthly by maternal report; observed the attainment of 7 motor milestones at 6, 12, and 18 mo of age; and conducted a comprehensive assessment of motor, language, and socioemotional development and executive function at 18 mo of age. The primary analysis was by intention-to-treat. Results: By maternal report, children in the LNS group achieved walking alone (B = 0.53; 95% CI: 0.11, 0.94; P = 0.034) and waving goodbye (B = 0.60; 95% CI: 0.12, 1.08; P = 0.040) earlier than the IFA group and standing with assistance earlier than the MMN group (B = 0.51; 95% CI: 0.12, 0.89; P = 0.029). By researcher observation, there was a trend (P = 0.052) for a greater percentage of children in the LNS group (58%) to walk alone at age 12 mo than in the IFA (49%) and MMN (49%) groups. At age 18 mo, there were no significant differences between groups in any scores. Conclusion: Although provision of SQ-LNSs to pregnant women and infants in Malawi may affect the age of acquisition of certain developmental milestones, it did not affect our assessments of motor, language, socioemotional, or executive function skills at 18 mo of age. This trial was registered at clinicaltrials.gov as NCT01239693.Am J Clin Nutr 2016;103:784-93.

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Effects of Maternal Worm Infections and Anthelminthic Treatment during Pregnancy on Infant Motor and Neurocognitive Functioning

Cited by 35 publications

References 71 publications

Linear Growth and Child Development in Burkina Faso, Ghana, and Malawi

Linear Growth and Child Development in Burkina Faso, Ghana, and Malawi

Early child development in children who are HIV‐exposed uninfected compared to children who are HIV‐unexposed: observational sub‐study of a cluster‐randomized trial in rural Zimbabwe

Effects of maternal and child lipid-based nutrient supplements on infant development: a randomized trial in Malawi

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