Journal Article

Anthropometric and sociodemographic variables, but not preconception or prenatal maternal nutrition supplementation, predict neurodevelopment in offspring of the ‘Women First’ trial

Derman, Richard J., Saleem, Sarah, Bauserman, Melissa, Lokangaka, Adrien, Waldrop, Stephanie, Koso‐Thomas, Marion, Goudar, Shivaprasad S., Biasini, Fred, Figueroa, Lester, Ali, Sumera A., Kemp, Jennifer F., Westcott, Jamie E., Goldenberg, Robert L., Dhaded, Sangappa M., Das, Abhik, Krebs, Nancy F., Chowdhury, Dhuly, Hambidge, Michael, Garcés, Ana, Tshefu, Antoinette

2024

Overview

Multiple 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. Key messages Preconception and prenatal maternal nutrition is important to ensure adequate fetal growth and healthy birthweight. Preconception and prenatal maternal nutritional supplementation was not associated with young child neurodevelopment but has been shown to improve post‐natal growth. Post‐natal linear growth is consistently associated with offspring neurodevelopment at 24 months. Maternal education to foster responsive caregiving, and opportunities for early learning in the home also positively impact offspring neurodevelopmental outcomes. These findings underscore the importance of multi‐dimensional aspects essential for children to reach their full developmental potential. The study examined the effects of maternal nutrition supplementation started before or during pregnancy (stopped at delivery) on offspring development at 24 months of age. The maternal intervention was not significantly associated with neurodevelopment, but maternal education, fetal and post‐natal growth and home environment were all associated with better developmental outcomes.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Adult / Anthropometry / Anthropometry - methods / Birth weight / Caregiving / Change agents / Child development / Child Development - physiology / Child, Preschool / Children / Dietary Supplements / Education / Families & family life / Female / Home environment / Humans / Infant / infant neurodevelopment / Infants / Intervention / Learning / linear growth / Male / Maternal and infant welfare / maternal nutrition supplement / Maternal Nutritional Physiological Phenomena - physiology / Measures / Mothers / nurturing care / Nutrition / Offspring / Original / Parent educational background / Postpartum period / preconception / Preconception Care - methods / Pregnancy / Prenatal care / Prenatal Care - methods / Prenatal Nutritional Physiological Phenomena / Secondary education / Sociodemographic Factors / Sociodemographics / Socioeconomic Factors / SQ‐LNS / Women / Young Adult