Cumulative febrile, respiratory illness tied to poor brain development in infants

Cumulative febrile and respiratory illnesses among infants are significantly associated with negative neurodevelopmental and growth outcomes, suggests a recent study.

A total of 499 infants 0‒3 months of age living in a resource-limited region of rural southwest Guatemala were enrolled and underwent weekly at-home surveillance for caregiver-reported cough, fever, vomiting/diarrhoea between June 2017 and July 2018.

The authors also assessed the anthropometric characteristics and tested the neurodevelopment of infants using the Mullen Scales of Early Learning (MSEL) at enrolment, 6 months, and 1 year.

Of the infants, 430 (86.2 percent) completed all procedures and proceeded to the final analysis. At 12‒15 months of age, 140 (32.6 percent) infants had stunted growth (length-for-age Z score <‒2) and 72 (16.7 percent) presented with microcephaly (occipital-frontal circumference <‒2).

Multivariate analysis revealed a marginal or significant association of greater cumulative instances of reported cough illness (beta, ‒0.08/illness-week; p=0.06) and febrile illness (beta, ‒0.36/illness-week; p<0.001) with lower MSEL Early Learning Composite Score at 12‒15 months, respectively.

No association was observed with any illness (ie, cough, fever, and/or vomiting/diarrhoea; p=0.27) or with cumulative instances of diarrhoeal/vomiting illness alone (p=0.66). Likewise, there was no association seen between cumulative instances of illness and stunting or microcephaly at 12‒15 months.

“Infectious disease exposures in early life are increasingly recognized as a risk factor for poor subsequent growth and neurodevelopment,” the authors said.

“Future studies should explore pathogen-specific illnesses, host response associated with these syndromic illnesses, and their association with neurodevelopment,” they noted.