Mechanistic pathways from early gestation through infancy and neurodevelopment

Sangshin Park, David C. Bellinger, Meredith Adamo, Brady Bennett, Nam Kyong Choi, Palmera I. Baltazar, Edna B. Ayaso, Donna Bella S. Monterde, Veronica Tallo, Remigio M. Olveda, Luz P. Acosta, Jonathan D. Kurtis, Jennifer F. Friedman

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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.

Original languageEnglish
Article numbere20161843
Issue number6
StatePublished - Dec 2016

Bibliographical note

Publisher Copyright:
Copyright © 2016 by the American Academy of Pediatrics.


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