Effects of pre- and post-natal lipid-based nutrient supplements on infant development in a randomized trial in Ghana

• Published in: Early human development Vol. 99; pp. 43 - 51
• Main Authors: Prado, Elizabeth L., Adu-Afarwuah, Seth, Lartey, Anna, Ocansey, Maku, Ashorn, Per, Vosti, Steve A., Dewey, Kathryn G.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.08.2016
• Subjects: Adult; Advanced Basic Science; Child Development; Dietary Supplements; Executive function; Fatty Acids - administration & dosage; Fatty Acids - therapeutic use; Female; Ghana; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Language development; Lipid-based nutrient supplements; Male; Malnutrition - prevention & control; Malnutrition - therapy; Maternal Nutritional Physiological Phenomena; Micronutrients - administration & dosage; Micronutrients - therapeutic use; Motor development; Multiple micronutrients; Neonatal and Perinatal Medicine; Pregnancy; Socio-emotional development; iLiNS; Executive function; Motor development; Socio-emotional development; IFA; PSED; CDI; Multiple micronutrients; FCI; MUAC; MMN; SQ-LNS; LNS; KDI; Lipid-based nutrient supplements; HFIA; Language development; Hb; ZPP; BMI; MGRS; WHO; mid-upper arm circumference; household food insecurity access; International Lipid-Based Nutrient Supplements; iron and folic acid; hemoglobin; small quantity lipid-based nutrient supplements; multiple micronutrients; family care indicators; profile of socio-emotional development; communicative development inventory; World Health Organization; body mass index; lipid-based nutrient supplements; Kilifi developmental inventory; zinc protoporphyrin; Multi-center Growth Reference Study
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2016.05.011

Maternal and infant undernutrition is negatively associated with infant development. We tested the hypothesis that provision of small-quantity lipid-based nutrient supplements (SQ-LNS) to pregnant women and infants positively affects infant development. 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. 1320 pregnant women in Ghana enrolled in the trial; 1173 of their children participated in developmental assessment. 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. 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). While provision of maternal and child SQ-LNS in Ghana may affect walking at 12months, it did not affect infant development at 18months. •Few studies have examined the effects of combined pre- and post-natal nutritional supplementation on child development.•A greater percentage of children who received SQ-LNS were able to walk at age 12 months, compared to a control group.•At age 18 months, no differences were found between groups in motor, language, socio-emotional, or executive function scores.