Identification of nutritionally modifiable hormonal and epigenetic drivers of positive and negative growth deviance in rural African fetuses and infants: Project protocol and cohort description
Open Access
- 24 February 2020
- journal article
- Published by F1000 Research Ltd in Gates Open Research
Abstract
Growth retardation (stunting, wasting and poor organ development) among children in low-income countries has major short and long-term health consequences yet very little is known about the nutritional and environmental influences on the key hormonal axes regulating child growth in these settings, nor the tempo and timing of faltering episodes. Here we describe the study protocol and provide a cohort description of the Hormonal and Epigenetic Regulators of Growth (HERO-G) study. This prospective cohort study from rural Gambia, West Africa, followed mothers and children longitudinally from pre-conception, through pregnancy, delivery, and to two years of child age A total of 251 eligible mother-infant pairs were recruited into the HERO-G study, with 206 (82%) followed up until two years of age. Women were seen at scheduled antenatal appointments at 20, 28 and 36 weeks of gestation, and at delivery, where possible. Between one week and 12 months of age, infants were visited every second day for collection of detailed anthropometry and morbidity data. Infants identified as about to enter a growth faltering episode at these visits entered a more detailed 20-day protocol, with the collection of dried blood spots, anthropometry and body composition. All infants were seen for scheduled clinic visits at 3, 6, 9, 12, 18 and 24 months of age for clinical examination and venous blood draw. Data from the HERO-G study is being used to explore three major mechanistic pathways influencing growth: 1) genome-wide investigations for signatures of epigenetic effects on any loci that might affect growth; 2) frequent anthropometric measurement coupled with non-invasive monitoring for rapid identification and interrogation of real-time faltering patterns and aetiology; 3) focused measurement of hormones and cytokines that act together in an integrated manner, both in utero and after birth, to coordinate patterns of growth with immune activation, inflammation, and nutritional status.Funding Information
- Department for International Development, UK Government (MC-A760-5QX00)
- Medical Research Council (MC-A760-5QX00)
- Bill and Melinda Gates Foundation (OPP1066932)
This publication has 21 references indexed in Scilit:
- Impact of Two Forms of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Hair Cortisol Concentrations Among Rural Laotian Children: A Randomized Controlled TrialNutrients, 2018
- Early-Life Nutritional Programming of Health and Disease in The GambiaAnnals of Nutrition and Metabolism, 2017
- Growth faltering in rural Gambian children after four decades of interventions: a retrospective cohort studyThe Lancet. Global Health, 2017
- Cohort Profile: The Kiang West Longitudinal Population Study (KWLPS)—a platform for integrated research and health care provision in rural GambiaInternational Journal of Epidemiology, 2015
- Maternal and child undernutrition and overweight in low-income and middle-income countriesThe Lancet, 2013
- Growth Faltering in Low-Income CountriesPublished by S. Karger AG ,2013
- Child Health, Developmental Plasticity, and Epigenetic ProgrammingEndocrine Reviews, 2010
- Fifty-year mortality trends in three rural African villagesTropical Medicine & International Health, 2004
- Growth Faltering in Rural Gambian Infants Is Associated with Impaired Small Intestinal Barrier Function, Leading to Endotoxemia and Systemic InflammationJournal of Nutrition, 2003
- Intestinal permeability, mucosal injury, and growth faltering in Gambian infantsThe Lancet, 1991