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. 2024 Dec 24;8(1):e002840.
doi: 10.1136/bmjpo-2024-002840.

Impact of maternal antenatal nutrition and infection treatment interventions on Longitudinal Infant Development and Growth in rural Ethiopia: protocol of the LIDG child follow-up study

Firehiwot Workneh  1 , Theresa I Chin  2   3   4 , Kalkidan Yibeltal  5 , Nebiyou Fasil  6 , Krysten North  7   3 , Sarah K G Jensen  8   9 , Workagegnhu Tarekegn Kidane  10 , Mulatu Melese  11 , Sitota Tsegaye  10 , Yoseph Yemane Berhane  1 , Unmesha Roy Paladhi  7   3   4 , Betelhem Haimanot Abate  12 , Atsede Teklehaimanot  13 , Tizita Lemma Melka  14 , Stephen Pihl  8 , Winko W An  3   8 , Fred Van Dyk  15 , Luke C Mullany  15 , Lian V Folger  7 , Sara Cherkerzian  7   3 , Sonya V Troller-Renfree  16 , Moriah E Thomason  17 , Maria Andersson  18 , Terrie Inder  19 , Charles A Nelson  3   8 , P Ellen Grant  3   8 , Parul Christian  15 , Alemayehu Worku  1 , Yemane Berhane  1 , Anne Cc Lee  7   3   4
Affiliations

Impact of maternal antenatal nutrition and infection treatment interventions on Longitudinal Infant Development and Growth in rural Ethiopia: protocol of the LIDG child follow-up study

Firehiwot Workneh et al. BMJ Paediatr Open. .

Abstract

Introduction: Maternal undernutrition and inflammation in utero may significantly impact the neurodevelopmental potential of offspring. However, few studies have investigated the effects of pregnancy interventions on long-term child growth and development. This study will examine the effects of prenatal nutrition and infection management interventions on long-term growth and neurodevelopmental outcomes of offspring.

Methods: The Enhancing Nutrition and Antenatal Infection Treatment ('ENAT') study (ISRCTN15116516) was a pragmatic, open-label, 2×2 factorial, randomised clinical effectiveness study implemented in 12 rural health centres in Amhara, Ethiopia. The study enrolled 2399 pregnant women who were randomised to receive routine care, an enhanced nutrition package (iron and folic acid, monthly household supply of iodised salt, and micronutrient-fortified balanced energy protein supplement for undernourished women), an enhanced infection management package (genitourinary tract infection screening and treatment, and enhanced deworming), or both packages. In the present Longitudinal Infant Development and Growth study, a subset of 480 children of mothers from ENAT will be recruited equally from each of the four study arms and visited at 12, 18, and 24 months of postnatal age. We will evaluate a range of domains and deploy multiple measures to assess child neurodevelopment, including resting electroencephalography and visual evoked potentials, Hammersmith Infant Neurological Examination, eye-tracking, Bayley Scales of Infant and Toddler Development (Bayley-III), and Magnetic Resonance Imaging (MRI).

Discussion: This study will advance understanding of the impact of nutrition and inflammation in pregnancy on long-term offspring neurodevelopment. This study aims to fill a critical knowledge gap on the benefits of prenatal interventions to promote the health of mothers and their offspring.

Ethics and dissemination: This study was approved by the Institutional Review Boards of Addis Continental Institute of Public Health (ACIPH/IRB/002/2022) and Mass General Brigham (2023P000461). Results will be disseminated to local and international stakeholders.

Trial registration number: NCT06296238.

Keywords: Child Health; Infant; Low and Middle Income Countries; Nutrition.

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Conflict of interest statement

Competing interests: ACCL and YB reports funding from the Bill & Melinda Gates Foundation, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). SVT-R reports receiving consulting fees from the NICHD funding granted to ACCL.

Figures

Figure 1
Figure 1. Design and participant flow of the ENAT parent RCT and LIDG child follow-up study. ENAT, Enhancing Nutrition and Antenatal Infection Treatment; LIDG, Longitudinal Infant Development and Growth; RCT, randomised controlled trial.
Figure 2
Figure 2. Concept diagram showing pathways of ENAT study interventions and effects on child neurodevelopment. ENAT, Enhancing Nutrition and Antenatal Infection Treatment.
See this image and copyright information in PMC

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