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Topical Area: Maternal, Perinatal and Pediatric Nutrition

Maternal, Perinatal and Pediatric Nutrition (II) (Poster Session)

(P07-039-23) Nutritional Predictors of Early Child Development Outcomes at 24 Months of Age Among a Cohort of Moderately LBW Infants in India and Tanzania: A Prospective Cohort Study

Sunday, July 23, 2023
12:45 PM – 1:45 PM ET
Location: Poster Board 508

    Presenting Author(s)

  • Rana R. Mokhtar, PhD, MA, MPH

    Research Associate
    Ariadne Labs, Harvard University T.H. Chan School of Public Health and Brigham and Women's Hospital
    Cambridge, Massachusetts, United States

    • Co-Author(s)

  • LV

    Linda Vesel, PhD MPH

    Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital

  • RB

    Roopa M. Bellad

    KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India

  • SD

    Sangappa Dhaded, MD

    KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
    Belagavi, Karnataka, India

  • KE

    Ki-Do Eum

    Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital

  • KM

    Karim P. Manji, MMED, MPH

    Muhimbili University of Health and Allied Sciences

  • SS

    Sarah S. Somji

    Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

  • CS

    Christopher R. Sudfeld

    Harvard T.H. Chan School of Public Health

  • SV

    Sunil S. Vernekar

    KLE Academy of Higher Education and Research’s Jawaharlal Nehru Medical College, Belgaum, Karnataka, India

  • KS

    Katherine E.A. Semrau, PhD, MPH

    Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital

Disclosure(s):
Rana R. Mokhtar, PhD, MA, MPH: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Moderately low birthweight (MLBW; 1500-2499g) infants are at risk for early child development (ECD) deficits. We aimed to: (1) describe complementary feeding (CF) diet quality at nine and 12 months; and (2) assess the impact of CF diet quality on ECD at 24 months among MLBW infants in India and Tanzania.

Methods: Mother-infant dyads were followed from birth to 24 months between September 13, 2019 and February 24, 2022 as part of the Low Birthweight Infant Feeding Exploration study. We used minimum dietary diversity (MDD) and consumption of animal source foods (ASF) as indicators of CF diet quality, measured using 24-hour recall at nine and 12 months. Growth anthropometrics (z scores for weight-for-age (WAZ), weight-for-length  (WLZ), and length-for-age (LAZ)) were measured at 12 months. The primary outcome, ECD, was assessed at 24 months using the Caregiver Reported Early Development Instruments (CREDI). Linear regression models, adjusted for infant and maternal covariates, were used to examine the association between CF diet quality and ECD or growth and ECD.

Results: Of the 617 dyads enrolled, 529 (85.7%) completed follow-up to 24 months. Of these, 26.5% did not achieve MDD, and 47.6% did not consume ASF at both nine and 12 month visits combined. Infants who did not consume ASF at nine and 12 months had significantly lower CREDI z scores across all four domains compared to infants consuming ASF at both visits [cognitive mean (SD) [both -0.10 (0.81) vs neither -0.35 (0.58)], motor [0.05 (0.97) vs -0.39 (0.72)], language [-0.19 (0.93) vs -0.41 (0.72)], and social-emotional (SEM) [-0.06 (0.73) vs -0.24 (0.52)]]. Similarly, infants who did not achieve MDD at both visits had significantly lower CREDI z-scores for cognitive [both -0.10 (0.81) vs neither -0.35 (0.58)], motor [-0.03 (0.87) vs -0.34 (0.81)], and SEM [-0.12 (0.67) vs -0.23 (0.54)] domains compared to infants who achieved MDD at both visits. Further, every unit increase in WAZ and WLZ at 12 months was associated with significantly higher overall CREDI z-score at 24 months (β =.13, (95% CI: 0.05, 0.20) and β=0.14, (95% CI: 0.08, 0.20), respectively).

Conclusions: This study supports the linkage between optimal CF practices and ECD for MLBW infants and reinforces the need to apply the nurturing care framework which integrates health, nutrition, and ECD in early childhood.

Funding Sources: Bill & Melinda Gates Foundation