Mechanistic Pathways From Early Gestation Through Infancy and Neurodevelopment

Abstract

OBJECTIVE: To identify pathways through which pre-and postnatal factors directly or indirectly affect infant neurodevelopment at 12 months of age among Filipino infants. METHODS: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. RESULTS: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. CONCLUSIONS: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. Dr Park conceptualized and designed the study, completed data analysis, drafted the original manuscript, and revised and reviewed the manuscript; Drs Baltazar and Tallo designed the data collection instruments and coordinated and supervised data collection at all sites; Drs Ayaso and Monterde designed the data collection instruments, received training in administration of the Bayley Scales of Infant Development, third edition, and administered these tests, and assessed nutritional status of infants at their follow-up visits; Dr Acosta developed study protocols, WHAT'S KNOWN ON THIS SUBJECT: Studies have identifi ed independent risk factors for impaired infant neurodevelopment, including birth weight, nutritional status, and feeding practices, yet few examined the pathways through which these factors directly or indirectly infl uence infant neurodevelopment. WHAT THIS STUDY ADDS:A longitudinal examination of risk factors from early gestation to 12 months of age identifi ed mechanistic pathways through which known (maternal cognition, infant nutrition) and newly identifi ed (maternal iron status) risk factors impact neurodevelopment.

Associations between maternal cytokine levels during gestation and measures of child cognitive abilities and executive functioning

“…Throughout the life course, childhood neurodevelopmental delays and cognitive impairments extend to poor academic achievement, higher engagement in health risk behaviors, increased risk for chronic disease and mental health problems, and lack of economic productivity in adulthood (Engle et al, 2007; Walker et al, 2011; Heckman, 2008; Heckman and Raut, 2016; Shonkoff, 2016). Previous studies indicate that both genetic factors (Sniekers et al, 2017; Gialluisi et al, 2014; Hansell et al, 2015) and the prenatal milieu profoundly affect brain development and neurodevelopmental abilities later in childhood (Park et al, 2016; von Ehrenstein et al, 2012; Singer et al, 2016). A better understanding of the prenatal factors contributing to suboptimal cognitive abilities and neurodevelopmental outcomes could be useful to developing prevention strategies to promote optimal development in these areas.…”

Efecto Spillover en los cuidadores de infantes de 1.5 a 5 años durante la pandemia del COVID-19

“…Las características sociodemográficas de los cuidadores pueden influir en la respuesta al estrés (2) por la cuarentena , a su vez modificar la interacción entre los cuidadores y los infantes, lo que afecta el (3)(4)(5)(6)(7)(8)(9)(10)(11) apego en vez de generar ansiedad en los infantes .…”

“…El estatus socio-económico bajo, incrementa el riesgo a exponerse a eventos/experiencias negativas relacionadas con el entorno donde viven, como pueden ser el desorden o inestabilidad familiar; estos eventos negativos en la vida generan un disregulación biológica similar a un estado inmune inflamatoria que conlleva a cambios epigenéticos en el neurodesarrollo de manera negativa, también crea el efecto de apagado, que disminuye la percepción de estímulos nocivos del entorno e incluye los estímulos adecuados, afectando los eje social y del (5)(6)(7)(8)(9)(10)(11) lenguaje , estas señales de retroalimentación intervienen con la maduración y polarización (12) neuronal adecuada para el neurodesarrollo ; por lo cual están relacionadas con el desarrollo de (13) trastornos mentales en el adulto .…”

Socioeconomic status and early blood concentrations of inflammation-related and neurotrophic proteins among extremely preterm newborns

“…This assessment was initially intended to approximate the heritable component of the child’s IQ. However, here this information is offered as a correlate/surrogate of low socioeconomic (SES)[ 23 ].…”