Mother-child hemoglobin at preconception and first 1000 days and child development at 6 years

孕前和前 1000 天的母子血红蛋白以及 6 岁时的儿童发育

• 批准号: 10042692
• 负责人: MELISSA Fox YOUNG
• 金额: $ 7.8万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-10 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10042692
• 关键词: 6 year old; Address; Adult; Affect; Age; Anemia; Birth; Caucasians; Child; Child Development; Child Health; Cognition; Conceptions; Data; Data Analytics; Development; Europe; Gestational Age; Goals; Guidelines; Health; Hemoglobin; Hemoglobin concentration result; Infant Development; Intelligence; Knowledge; Life; Literature; Longitudinal Studies; Maternal Mortality; Maternal and Child Health; Measurement; Measures; Medicine; Methods; Micronutrients; Modeling; Monitor; Mothers; Motor; North America; Outcome; Performance; Personal Satisfaction; Pharmacy facility; Policies; Population; Positioning Attribute; Pregnancy; Pregnant Women; Premature Birth; Prevention; Prospective cohort; Randomized; Recommendation; Research; Research Personnel; Role; Sampling; Small for Gestational Age Infant; Statistical Methods; Supplementation; Sustainable Development; Time; Universities; Vietnam; Wechsler Scales; Woman; World Health Organization; analytical method; base; child battery; cognitive function; design; double-blind placebo controlled trial; early childhood; experience; functional outcomes; global health; innovation; meetings; mental development; nutrition; offspring; pregnant; programs; prospective; public health priorities; reproductive; response; systematic review

Anemia is an important global health problem. Concerns about the validity of the cut-off values for hemoglobin (Hb) that WHO issued in 1968 have been raised. Several systematic reviews, including a recent one by Dr. Young (PI), reveal a paucity of data and insufficient evidence on relationships between anemia and functional consequences, especially child health and development (CHD). WHO has issued a call for analyses that can inform the appropriateness of its cut-off values for a variety of outcomes, including CHD. We have a unique opportunity to examine the relationships between maternal and child Hb measured across the continuum of preconception, pregnancy and early childhood and a battery of CHD measures. The data we will use are from a randomized, double-blinded, placebo-controlled trial of preconceptional micronutrient supplementation (NCT01665378; PRECONCEPT study; PI: Ramakrishnan) conducted in Vietnam. Prospective data are available from preconception (n=5011 women), through pregnancy and delivery for 1599 livebirths, and from birth to 6 y for 1290 children. To assess timing-specific influences of mother/child Hb, valid statistical methods are needed to generate uncorrelated estimates of Hb changes over time. We will apply innovative conditional modeling methods to answer the following questions. 1: Are maternal preconception Hb concentrations associated with CHD from birth through age 6y? Maternal preconception Hb concentrations will be positively associated with CHD outcomes [1. birth size, 2. Hb at 3, 12 and 24 mo, 3. motor and mental development (Bayley scales for infant development at 12 and 24 mo, and Wechsler scale for global intelligence, performance and verbal scores at 6y). 2: What is the role of timing of changes in maternal Hb across preconception to delivery on CHD? The relative importance of maternal Hb for CHD will vary across four periods: preconception, preconception - trimester 1, trimester 1 - 2, and trimester 2 - 3. 3: What is the role of timing of child Hb changes across the first 2 years of life on child cognition at 6y? The relative importance of child Hb on cognition will vary across three periods: 3mo, 3mo - 1y, and 1y - 2y. The proposed research will fill important gaps in current knowledge about relationships between maternal and child Hb before and during the 1st 1000 days of life and child cognitive functioning through the age of 6 years. Important strengths include availability of prospective, high quality data on a large sample of mother-child pairs from preconception through age 6 y, the application of innovative statistical methods and a highly qualified team that includes junior (PI: Young, early stage investigator) and senior experienced investigators from Emory University and Thai Nguyen University of Medicine and Pharmacy in Vietnam.

贫血是一个重要的全球健康问题。对截断值有效性的关注