Alpha Omega Alpha Honor Medical Society

Systemic Inflammatory Markers are Predictive of Neurodevelopmental Outcomes in Bangladeshi Children Growing up in Adversity

Investigator: Nona M. Jiang

Mentors: William A. Petri, Jr., M.D., Ph.D., Charles A. Nelson, Ph.D.

Background:
Hundreds of millions of children under 5 years of age in low- and middle-income countries fail to meet their full developmental potential. Biological mechanisms that underpin the impaired development of these children are unknown. We aimed to validate and extend our recently published findings of an association of inflammatory markers with neurodevelopmental outcomes in children growing up in adversity.

Methods:
Children in an urban slum in Dhaka, Bangladesh were followed from birth to 36 months of age. Inflammation was measured using cytokines and soluble CD14 (sCD14) at 18 weeks, and CRP at 6, 18, 40, and 53 weeks. Trained psychologists assessed cognitive, language, motor, and social emotional development using a culturally-adapted version of the Bayley Scales of Infant and Toddler Development, Third Edition at 78 (n = 205) and 104 weeks of age (n = 422). Pattern-reversal visual evoked potentials (VEP) were recorded in a subset of children (n = 32) at 36 months of age as another measure of neurodevelopment. We tested for the ability of inflammatory markers to predict developmental outcomes, independent of known predictors.

Results:
Each 10 pg/mL increase in soluble CD14 was associated with a 1.1 to 2.0 decrement in cognitive and motor scores at 78 weeks and in all domains at 104 weeks. Elevated CRP at 40 weeks of age was significantly associated with lower cognitive scores at 78 weeks of age (all p < 0.05). In the grand-averaged waveform, the cohort showed a robust VEP response to pattern-reversal stimuli.

Conclusions:
Systemic inflammatory markers, including sCD14, were significantly associated with poor neurodevelopmental outcomes. The identification of these inflammatory markers may allow us to identify at-risk children for targeted interventions.

Last modified: 2/03/2017

Updated on February 3, 2017.


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