Effects of prenatal food and micronutrient supplementation on infant development: a randomized trial from the Maternal and Infant Nutrition Interventions, Matlab (MINIMat) study

Am J Clin Nutr. 2008 Mar;87(3):704-11. doi: 10.1093/ajcn/87.3.704.

Abstract

Background: Few data exist for the effects of multiple micronutrient (MM) or food supplementation to undernourished pregnant women on their offsprings' development.

Objective: We aimed to compare the effects on infant development of early (8-10 wk gestation) or usual ( approximately 17 wk gestation) supplementation with food and MM, 30 mg Fe + 400 microg folate, or 60 mg Fe + 400 microg folate.

Design: A large, randomized, controlled trial of pregnancy supplementation was conducted in Bangladesh. A subsample of infants (n = 2853) were assessed on 2 problem-solving tests (support and cover tests), the motor index of the Bayley Scales of Infant Development, and Wolke's behavior ratings at 7 mo of age.

Results: There were no significant effects of any intervention in the group as a whole. However, infants of undernourished mothers [body mass index (BMI; in kg/m2) < 18.5] who received early food supplementation performed slightly but significantly (P = 0.035) better on the support test than did infants of mothers who received usual food supplementation (z score: 0.17; 95% CI: 0.01, 0.33). There were no benefits in infants of higher-BMI mothers (P = 0.024 for BMI x food interaction). Children of low-BMI mothers who received MMs had slightly better motor scores (z score: 0.28; 95% CI: 0.08, 0.48) and activity ratings (z score: 0.24; 95% CI: 0.037, 0.45) than did those who received 30 mg Fe + 400 microg folate, whereas other children did not benefit (P = 0.05 for both motor scores and BMI x micronutrients and for activity and BMI x micronutrients).

Conclusions: Small benefits from early food and MM supplementation were found in infants of low-BMI but not of high-BMI mothers. However, the benefits were of doubtful functional importance, and longer follow-up is required to determine programmatic implications.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Anthropometry
  • Bangladesh
  • Body Mass Index
  • Child Development / drug effects*
  • Child Development / physiology
  • Dietary Supplements*
  • Female
  • Folic Acid / administration & dosage
  • Humans
  • Infant
  • Iron, Dietary / administration & dosage
  • Micronutrients / administration & dosage*
  • Nutritional Status
  • Pregnancy
  • Prenatal Nutritional Physiological Phenomena / physiology*
  • Problem Solving / drug effects*
  • Problem Solving / physiology
  • Psychomotor Performance / drug effects*
  • Psychomotor Performance / physiology
  • Time Factors

Substances

  • Iron, Dietary
  • Micronutrients
  • Folic Acid