Maternal, Newborn, and Adolescent Health

Lindsay Allen of ARS Western Human Nutrition Research Center in the U.S. will develop methods to rapidly and accurately measure concentrations of multiple micronutrients (vitamins and minerals) in small volumes of human breast milk. This will enable them to test whether micronutritional supplements during lactation can boost infant health and development. In Phase I, they established new methods to detect low concentrations of specific micronutrients including vitamin B12, iron, copper and zinc.

Clare Elwell of University College London in the United Kingdom is using non-invasive optical brain imaging (near-infrared spectroscopy) to assess cognitive function in malnourished infants and children in low-resource settings over time. The technology is relatively low-cost and portable, and their approach could be used to determine the impact of malnutrition on the developing brain and guide nutrition-related interventions.

Yun Yun Gong of Queen’s University Belfast in the United Kingdom and colleagues will identify mechanistic biomarkers of child stunting caused by the dietary contaminant aflatoxin, which is common in many parts of sub-Saharan Africa. They will determine the mechanism by which aflatoxin inhibits growth in early life using blood samples and growth charts from 300 children in Gambia and analyzing the relationship between aflatoxin exposure and changes in insulin-like growth factor signaling, epigenetic marks, and gene expression.

Robin Bernstein of the George Washington University in the U.S. and colleagues will undertake one of the most detailed longitudinal studies to date to examine the effects of epigenetic and hormonal factors on growth during the first 1000 days of life. Assessment of a variety of parameters, including infectious exposures and hormone levels, as well as epigenome and transcriptome analyses will be collected from the 13th week of gestation through infant and early childhood from a cohort of 200 Gambian children.

David Mabey of the London School of Hygiene and Tropical Medicine in the United Kingdom and his team will test whether treatment with the broad-spectrum antibiotic azithromycin can prevent growth faltering linked to environmental enteropathy, which is prevalent in young children of developing countries. They will utilize a double blind, randomized, controlled trial of Malawian children aged 1-60 months, and analyze growth over a two year period after a single administration of either the antibiotic or a placebo control.

Sean Limesand of the University of Arizona in the U.S., along with co-investigators, will test whether infants with intrauterine growth restriction, caused during gestation by oxygen and nutrient deprivation, could benefit from pharmacological intervention using well-characterized adrenergic drugs to improve skeletal muscle metabolism. Intrauterine growth restriction affects around 24% of babies born in developing countries and leads to perinatal morbidity and mortality.

Charles King of Case Western Reserve University in the U.S. and his team will study how chronic parasitic infections in pregnant mothers affect infant immunity and childhood development. Using existing and prospective maternal-child cohorts in Kenya they will analyze the effect of parasitic infections, such as schistosomiasis and intestinal helminths, encountered in utero on subsequent infant vaccine responses, and on general growth and development later in childhood.

Peter Gluckman of the University of Auckland in New Zealand and colleagues will test whether intrauterine growth retardation and childhood stunting, which are commonly seen in developing countries, are caused by epigenetic changes that can be corrected in pregnancy and infancy by modifying nutrition. Stunting is associated with many negative outcomes including decreased cognitive ability and immune function.

Daniel Roth of the Hospital for Sick Kids in Canada and colleagues will test whether endocrine factors cause stunting in early infancy. They will analyze parathyroid hyperactivity in a cohort of infants from Bangladesh, where stunting is estimated to affect almost half of all children under the age of 5. To uncover the mechanisms responsible for this hyperactivity, they will conduct a vitamin D supplementation trial and analyze maternal, cord, and infant plasma specimens for evidence of dysregulation of the parathyroid-vitamin D axis.

Lineo Matsela from Sefako Makgatho University in South Africa together with collaborators at the University of Alabama at Birmingham will develop a progesterone-impregnated cervical pessary with strain gauge sensors to identify cervical shortening and dilation and help prevent preterm labor. Preterm birth is a major cause of infant mortality. One of the best predictors is shortening of the cervix, which is currently detected by ultrasound and can then be treated by either vaginal progesterone or a pessary. However, none of these methods are practical in resource-limited settings.