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Enhancing Neurodevelopment.

Wednesday, 26 April 2023 / Published in Health, JOOTRH, News Item

Enhancing Neurodevelopment.

What is the correlation between maternal anemia and neurodevelopment?

This is the question that a new study at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) seeks to answer in the next couple of years.

The study funded by the Bill Gates Foundation is founded on the fact that maternal anemia in early pregnancy increases the risk of childhood neurodevelopmental disorders including autism spectrum disorder, attention deficit hyperactivity disorder, and intellectual disability.

The study is also supported by the facts such as the first years of life are critical and are the foundations of adult health, well-being, and productivity in addition low pregnancy iron specifically in the third trimester is associated with adverse infant neurodevelopment.

To ensure the success of the study, the Bill Gates Foundation has also donated a hyperfine MRI that will be used to calculate the magnetization transfer ratio (MTR) – myelination and brain maturity this is done while the infants are sleeping or still.

To affirm their commitment a delegation led by Sean Deoni, a senior Program technical lead neurodevelopment from Bill Gates Foundation visited JOOTRH, to understand the environment and access where the machine will be installed. 

The delegation comprised varied specialists from the University of British Columbia, Hyperfine Inc CT USA, Cardiff University UK, and ISMRM, Kings Collection London.

The team was accompanied by Dr Dicken Onyango and other officials from Child Health and Mortality Prevention Surveillance (CHAMPS) project as well as Pregnancy Risk Surveillance Innovation and Measurement Alliance (PRiSMA) officials and received by JOOTRH’s CEO Dr George Rae, together with members of the executive committee from the facility.

The hyperfine MRI that will be installed in two months will not only serve those enrolled in the study, but all infants needing MRI services at JOOTRH.  

 This study is a prospective maternal-infant birth cohort follow-up study in low-and middle-income countries

This study which will establish the impact of maternal anaemia on neurodevelopmental outcomes among infants will target women in the PRiSMA MNH sites specifically health facilities in the demographic surveillance systems.

 The duo is the Manyatta area in an urban setup, which records more than 1000 pregnancies annually, and Karemo in the rural areas which records about 2000 pregnancies annually.

The study is designed in such a way that about 1600 mothers and infants per site will be enrolled with the infant neurodevelopmental assessments done at three, six, and 12 months of infant age.

The objective of the study is to assess the impact of maternal anemia on infant neurodevelopment by GSED scores at three, six, and 12 months of age.

The second objective is to assess the association between maternal characteristics (age, education, occupation, ethnicity, religion, maternal depression, anemia status) and childhood neurodevelopmental outcomes at three, six, and 12 months of age

The study will also assess the impact of maternal anemia on infant brain volumetry and microstructure at three and 12 months of age.

The study will be employing the is using, the Global Scale for Early Development (GSED) to test tool for assessing neurodevelopment in children, its a tool validated by World Health Organization (WHO) in several countries. GSED measures short-form (SF), long-form (LF), and psychosocial form (PF).

Neurodevelopmental processes require iron through pregnancy and infancy, however, it’s not clear whether maternal iron deficiency has a direct impact on neurodevelopmental outcomes, whether the impact depends on the timing of exposure, and what domains of neurodevelopment are susceptible

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