The effects of prenatal use of folic acid and other dietary supplements on early child development.
OBJECTIVE
Our objective was to evaluate in an exploratory framework the effects of prenatal use of folic acid and other dietary supplements on child development at around 3 years of life.


METHODS
Data from the 1988 National Maternal Infant Health Survey and the 1991 follow-up supplement is used. Performance indicators are formed based on 16 developmental assessment items completed by the mother to measure overall as well as domain specific (language, personal-social, gross-motor and fine-motor) development. Pooled as well as separate analyses by child race are performed. Multinomial and binary outcome logistic regression is used and several maternal and household characteristics are included as covariates.


RESULTS
Folic acid use was associated with improved gross-motor development with a more pronounced effect among African-American children, but there was marginally significant poorer performance for the personal-social domain. Zinc and calcium use were associated with increased risks on the overall development scale and two other developmental domains. The negative effects of Zinc on overall development were only observed among white children. On the contrary, vitamin A was associated with decreased risks on the overall development scale only among white children.


CONCLUSIONS
Study results suggest that while prenatal folic acid supplementation may improve development at 3 years of age, further research is needed in this regard. The results also emphasize the importance of further research into the use of prenatal calcium and zinc supplementation in a US population.
Wehby
George L
GL
Department of Pediatrics, University of Iowa, 2182 ML, S Grand Ave, Iowa City, IA 52242, USA.
Murray
Jeffrey C
JC
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D002136:Calcium, Dietary / Q000008:administration & dosage; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019266:Iron, Dietary / Q000008:administration & dosage; D016015:Logistic Models; D008297:Male; D016742:Preconception Care / Q000379:methods; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D014801:Vitamin A / Q000008:administration & dosage; D014803:Vitamin B Complex / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage; D044465:White People; D015032:Zinc / Q000008:administration & dosage
D002136:Calcium, Dietary; D019266:Iron, Dietary; D014815:Vitamins; D014801:Vitamin A; D014803:Vitamin B Complex; D005492:Folic Acid; D015032:Zinc