It is hypothesized that maternal suboptimal zinc and folate nutriture will result in impaired neurodevelopment and an increased incidence of childhood disability, while supplementation of the mothers with these nutrients during pregnancy will result in improved function and fewer disabilities in their children.
Specific aims i nclude: 1) To determine the effect of prenatal supplementation with zinc on the neurodevelopmental status of children; 2) To determine the association between maternal and fetal zinc nutriture as assessed by determination of maternal and umbilical cord serum zinc and the neurodevelopmental status of children; 3) To determine the association between maternal and fetal folate nutriture as assessed by determination of maternal and umbilical cord serum folate and homocysteine concentrations and the neurodevelopmental status of children; 4) To determine the effect of other measures of maternal nutritional status such as serum ferritin, blood sugars and measures of maternal size as they interact with zinc and folate nutriture to affect the neurodevelopmental status of children; and 5) To determine the interaction between various measures of maternal nutritional status and familial and environmental characteristics on the neurodevelopmental status of children. To achieve these goals, the proposed investigation will be performed in two already defined cohorts of maternal-infant pairs. Each of these cohorts has unique attributes which will help us to understand various components of the relationship between maternal nutritional status and neurodevelopmental function in children. Cohort 1 consists of 580 African American maternal-infant pairs who in early pregnancy had low plasma zinc levels and who were randomized to receive either 25 mg of zinc daily or a placebo. Children born to mothers in this trial will be investigated at age five by performing a comprehensive evaluation of their neurodevelopmental status and these results will be correlated with zinc supplementation status and various measures of maternal nutriture. Cohort 2 consists of 930 predominantly African American maternal-infant pairs who have been studied extensively including a comprehensive evaluation of their children at age 5. These mothers received only folic acid and iron supplementation during their pregnancy. Zinc, folate, homocysteine, (as another measure of folate nutritional status) and ferritin levels in serum samples drawn at 17, 24, 30, 36 weeks and delivery, and from cord blood will be measured and correlated with the neurodevelopmental status of the children at age five. By analyzing data derived from these two cohorts, the relationship between various measures of maternal nutriture and the neurodevelopmental status of children will be better defined.
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