Early Growth and Impacts on Long-Term Neurodevelopment and Human Capital.

Background: Growth trajectories during the first 1,000 days from conception to 2 years influence human capital, predicting intelligence, skills and health in adults.

Summary: This review describes current evidence on the impacts of adverse pregnancy outcomes such as low birth weight, preterm birth, small for gestational age, and infant nutrition on long-term neurodevelopment and summarizes interventions that have proven to be effective in improving child development and further impact human capital. To date, no globally standardized measurements of child development in low-medium-income countries exist, and comparisons among studies using different developmental scales are challenging. In the perinatal period, birth weight, gestational age at delivery and elevated placental blood flow resistance have been identified as the main risk factors for global neurological delay, poor neurosensory development and cerebral palsy. Although these adverse neurological outcomes have decreased in developed settings, it is still a problem in low-resource populations. Nutritional deficiencies are the main drivers of developmental impairment, notably iron, iodine and folate deficiencies, and environmental stressors during pregnancy such as air pollution, exposure to chemicals, substance abuse, smoking, and maternal/parental psychiatric disorders can affect the developing brain. Interventions aiming to improve maternal macro- and micronutrient status, delayed cord clamping, exclusive breastfeeding and nurturing care have demonstrated to be effective strategies to prevent perinatal complications known to affect child development.