Join us for the next monthly OGHE Global Health Forum on Monday, April 27, from 12-1 pm in Roper Hall (Room 4302) OR online on zoom (https://zoom.us/j/3111814366?omn=97728086196). RSVP by 12 noon on Thursday, March 26 for a boxed lunch – if joining the in-person event.
Jeanette Van Steyn, MD, MPH
Neonatal-Perinatal Medicine Fellow, UNC Global Health Scholar
The association of pre and postnatal growth with neurodevelopmental outcomes in low- and middle-income countries: a secondary analysis of the ASPIRIN Trial
Abstract: Background: Millions of children in low- and middle-income countries (LMICs) do not reach their neurodevelopmental potential. Poor prenatal, postnatal growth are modifiable risk factors for neurodevelopmental impairment. This secondary analysis of the NICHD Global Network ASPIRIN Trial follow-up study evaluated associations of prenatal (low birth weight, LBW) and postnatal (stunting, wasting) growth with neurodevelopment.
Methods: Children from the ASPIRIN follow-up study across seven LMIC sites underwent Bayley Scales of Infant Development-III (BSID-III) testing at 36 months. Primary outcomes included BSID-III cognitive, language, and motor composite scores. Exposures were LBW, stunting, and wasting. Generalized linear models with generalized estimating equations estimated adjusted mean differences and 95% confidence intervals (CI), controlling for site, treatment arm, maternal characteristics, birth outcomes, breastfeeding, and family care indicators.
Results: Of 666 enrolled participants, 640 completed BSID-III cognitive assessments. LBW (17%), stunting (40%) and wasting (10%) were common. Stunting was associated with lower cognitive (–2.1, 95% CI –2.9 to –1.3), language (–1.9, 95% CI –2.8 to –1.0), and motor (–3.7, 95% CI –6.1 to –1.3) scores. Wasting was associated with lower language (–1.6, 95% CI –2.6 to –0.6) and motor (–2.2, 95% CI –3.2 to –1.1) scores. LBW was not significantly associated with any BSID-III domain.
Conclusions: Postnatal growth failure is associated with lower neurodevelopmental scores in LMICs; LBW showed no independent association. These findings underscore postnatal growth failure as a risk marker for adverse neurodevelopmental outcomes in early childhood and support the need for interventions to improve early childhood growth.
Bio: Jeanette Van Steyn, MD, MPH, is a third-year Neonatal-Perinatal Medicine fellow at the University of North Carolina at Chapel Hill. She graduated from the University of South Carolina School of Medicine in 2017 and subsequently commissioned as an officer in the United States Army. She completed her pediatric residency at Madigan Army Medical Center at Joint Base Lewis-McChord in 2020 and served as an active duty general pediatrician, pediatric hospitalist, and Battalion Surgeon at multiple duty stations from 2020 to 2023. Her early global health research, conducted in collaboration with the President’s Emergency Plan for AIDS Relief (PEPFAR), focused on maternal access to HIV care and associated infant outcomes.
Jeanette is a current third year Neonatal-Perinatal Medicine fellow. She completed her Master of Public Health in 2025 at the UNC Gillings School of Global Public Health, where her work focused on advancing equitable, community-engaged research practices and improving outcomes for vulnerable populations worldwide.
For her scholarly work with her mentor, Dr. Melissa Bauserman, Jeanette is studying how early life growth influences neurodevelopment among children in low- and middle-income countries using data from the National Institute of Child Health and Human Development (NICHD) Global Network for Women’s and Children’s Health Research.