Neurodevelopment, Nutrition, and Inflammation: The Evolving Global Child Health Landscape

Abstract

The last decade has witnessed major reductions in child mortality and a focus on saving lives with key interventions targeting major causes of child deaths, such as neonatal deaths and those due to childhood diarrhea and pneumonia. With the transition to Sustainable Development Goals, the global health community is expanding child health initiatives to address not only the ongoing need for reduced mortality, but also to decrease morbidity and adverse exposures toward improving health and developmental outcomes. The relationship between adverse environmental exposures frequently associated with factors operating in the prepregnancy period and during fetal development is well established. Also well appreciated are the developmental impacts (both short-and long-term) associated with postnatal factors, such as immunostimulation and environmental enteropathy, and the additional risks posed by the confluence of factors related to malnutrition, poor living conditions, and the high burden of infections. This article provides our current thinking on the pathogenesis and risk factors for adverse developmental outcomes among young children, setting the scene for potential interventions that can ameliorate these adversities among families and children at risk.

Effect of different composition of human milk and its fortification in body composition and neurodevelopment in a cohort of very preterm infants

“…Foram incluídas na coorte 33 crianças, com medianas (intervalos interquartílicos) de 30 (28)(29)(30)(31) semanas de IG e peso ao nascer de 1175 (1010-1408) g. Comparando com os 56 lactentes excluídos do estudo, alimentados com formula, os 33 lactentes que completaram o estudo tinham IG significativamente menor, menor prevalência de gémeos e maior tempo de internamento.…”

“…Thirty-three infants were included in the cohort, with a median (interquartile range) gestational age of 30 (28)(29)(30)(31) weeks and birthweight of 1175 (1010-1408) g. Compared with the 56-excluded formula-fed infants, the 33 infants who completed the study had significantly lower gestational age, lower prevalence of twins and stayed longer in hospital.…”

The relationship between preoperative fetal head circumference and 2‐year cognitive performance after laser surgery for twin‐twin transfusion syndrome

“…Furthermore, the children did not undergo serial formal postnatal evaluations at our institution to assess whether or not shifts in HC percentiles and/or BDI‐2 scores exist as the children continue to develop. Many postnatal environmental factors known to impact neurodevelopment such as living conditions, infections, and nutrition were not assessed in this study . Fourth, parental HC, intelligence quotient, and psychiatric disorders were not collected, and therefore we are unable to control for these potential confounders .…”

“…were not assessed in this study. 27,28 Fourth, parental HC, intelligence quotient, and psychiatric disorders were not collected, and therefore we are unable to control for these potential confounders. 29,30 Fifth, the number of patients with fetal HC measurements <3 rd percentile was relatively small (n = 18), the possibility of a negative affect from in utero microcephaly cannot be ruled out.…”

Magnesium Status in Children with Attention-Deficit/Hyperactivity Disorder and/or Autism Spectrum Disorder

“…Environmental factors [7], including nutrition [8], play a significant role in neurodevelopmental disorders. Particularly, children with ADHD [9] and ASD [10] are characterized by an impaired nutritional status.…”