title: Mechanistic Pathways From Early Gestation Through Infancy and Neurodevelopment.
abstract: 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.
authors.affiliation: Center for International Health Research, Rhode Island Hospital, and dvm.spark@gmail.com.|Departments of Pediatrics, and.
authors.forename: Sangshin
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.|Department of Neurology, Children's Hospital, Boston, Massachusetts.
authors.forename: David C
authors.initials: DC
authors.lastname: Bellinger
authors.affiliation: Center for International Health Research, Rhode Island Hospital, and.
authors.forename: Meredith
authors.initials: M
authors.lastname: Adamo
authors.affiliation: Center for International Health Research, Rhode Island Hospital, and.
authors.forename: Brady
authors.initials: B
authors.lastname: Bennett
authors.affiliation: Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.|Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.|Department of Health Convergence, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Nam-Kyong
authors.initials: NK
authors.lastname: Choi
authors.affiliation: Remedios Trinidad Romualdez Hospital, Tacloban City, Leyte, Philippines; and.|Research Institute for Tropical Medicine, Manila, Philippines.
authors.forename: Palmera I
authors.initials: PI
authors.lastname: Baltazar
authors.affiliation: Remedios Trinidad Romualdez Hospital, Tacloban City, Leyte, Philippines; and.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Ayaso
authors.affiliation: Remedios Trinidad Romualdez Hospital, Tacloban City, Leyte, Philippines; and.
authors.forename: Donna Bella S
authors.initials: DB
authors.lastname: Monterde
authors.affiliation: Research Institute for Tropical Medicine, Manila, Philippines.
authors.forename: Veronica
authors.initials: V
authors.lastname: Tallo
authors.affiliation: Research Institute for Tropical Medicine, Manila, Philippines.
authors.forename: Remigio M
authors.initials: RM
authors.lastname: Olveda
authors.affiliation: Research Institute for Tropical Medicine, Manila, Philippines.
authors.forename: Luz P
authors.initials: LP
authors.lastname: Acosta
authors.affiliation: Center for International Health Research, Rhode Island Hospital, and.|Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Kurtis
authors.affiliation: Center for International Health Research, Rhode Island Hospital, and.|Departments of Pediatrics, and.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Friedman
mesh_terms: D000328:Adult; D002657:Child Development; D003071:Cognition; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers; D065886:Neurodevelopmental Disorders / Q000209:etiology*; D009752:Nutritional Status; D010679:Philippines; D011247:Pregnancy; D012307:Risk Factors