Elizabeth L Prado1, Seth Adu-Afarwuah2, Anna Lartey2, Maku Ocansey3, Per Ashorn4, Steve A Vosti5, Kathryn G Dewey6. 1. Department of Nutrition, University of California Davis, 3253 Meyer Hall, One Shields Ave, Davis, CA, 95616, USA. Electronic address: elprado@ucdavis.edu. 2. Department of Nutrition and Food Science, University of Ghana, Legon, Box LG, 134, Legon, Accra, Ghana. 3. Department of Nutrition, University of California Davis, 3253 Meyer Hall, One Shields Ave, Davis, CA, 95616, USA; Department of Nutrition and Food Science, University of Ghana, Legon, Box LG, 134, Legon, Accra, Ghana. 4. Center for Child Health Research, University of Tampere School of Medicine and Tampere University Hospital, Arvo building, FIN33014, University of Tampere, Finland; Department of Paediatrics, Tampere University Hospital, POB 2000, FIN33521 Tampere, Finland. 5. Department of Agricultural and Resource Economics, University of California Davis, 2135 Social Sciences and Humanities, One Shields Ave, Davis, CA, 95616, USA. 6. Department of Nutrition, University of California Davis, 3253 Meyer Hall, One Shields Ave, Davis, CA, 95616, USA.
Abstract
BACKGROUND: Maternal and infant undernutrition is negatively associated with infant development. AIMS: We tested the hypothesis that provision of small-quantity lipid-based nutrient supplements (SQ-LNS) to pregnant women and infants positively affects infant development. STUDY DESIGN: In a partially double-blind randomized controlled trial, we compared the following daily maternal supplements during pregnancy and until 6months post-partum: iron/folic acid capsule (IFA), capsule containing 18 micronutrients (MMN), or 20g SQ-LNS. Children in the SQ-LNS group also received SQ-LNS from age 6 to 18months. The study is registered as NCT00970866. SUBJECTS:1320 pregnant women in Ghana enrolled in the trial; 1173 of their children participated in developmental assessment. OUTCOME MEASURES: We monitored the acquisition of 10 developmental milestones monthly by parental report, observed the attainment of 6 motor milestones at 6, 12, and 18months, and conducted detailed assessment of motor, language, socio-emotional, and executive function at 18months. RESULTS: By researcher observation, a greater percentage of children in the SQ-LNS group (53%) was able to walk alone at 12months than in the IFA group (43%; RR=1.23, 95% CI=1.02-1.49; p=0.025). We found no significant differences between groups in milestone acquisition by parent report or in any scores at 18months. The difference in mean z-scores between groups ranged from 0.03-0.13 for motor (p=0.84), 0.01-0.08 for language (p=0.46), 0.01-0.02 for socio-emotional (p=0.75), and 0.00-0.02 for executive function (p=0.95). CONCLUSION: While provision of maternal and child SQ-LNS in Ghana may affect walking at 12months, it did not affect infant development at 18months.
RCT Entities:
BACKGROUND: Maternal and infant undernutrition is negatively associated with infant development. AIMS: We tested the hypothesis that provision of small-quantity lipid-based nutrient supplements (SQ-LNS) to pregnant women and infants positively affects infant development. STUDY DESIGN: In a partially double-blind randomized controlled trial, we compared the following daily maternal supplements during pregnancy and until 6months post-partum: iron/folic acid capsule (IFA), capsule containing 18 micronutrients (MMN), or 20g SQ-LNS. Children in the SQ-LNS group also received SQ-LNS from age 6 to 18months. The study is registered as NCT00970866. SUBJECTS: 1320 pregnant women in Ghana enrolled in the trial; 1173 of their children participated in developmental assessment. OUTCOME MEASURES: We monitored the acquisition of 10 developmental milestones monthly by parental report, observed the attainment of 6 motor milestones at 6, 12, and 18months, and conducted detailed assessment of motor, language, socio-emotional, and executive function at 18months. RESULTS: By researcher observation, a greater percentage of children in the SQ-LNS group (53%) was able to walk alone at 12months than in the IFA group (43%; RR=1.23, 95% CI=1.02-1.49; p=0.025). We found no significant differences between groups in milestone acquisition by parent report or in any scores at 18months. The difference in mean z-scores between groups ranged from 0.03-0.13 for motor (p=0.84), 0.01-0.08 for language (p=0.46), 0.01-0.02 for socio-emotional (p=0.75), and 0.00-0.02 for executive function (p=0.95). CONCLUSION: While provision of maternal and child SQ-LNS in Ghana may affect walking at 12months, it did not affect infant development at 18months.
Keywords:
Executive function; Language development; Lipid-based nutrient supplements; Motor development; Multiple micronutrients; Socio-emotional development
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