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


METHODS
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.
Tofail
Fahmida
F
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. ftofail@icddrb.org
Persson
Lars Ake
LA
El Arifeen
Shams
S
Hamadani
Jena D
JD
Mehrin
Ferdina
F
Ridout
Deborah
D
Ekström
Eva-Charlotte
EC
Huda
Syed N
SN
Grantham-McGregor
Sally M
SM
D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry; D001459:Bangladesh; D015992:Body Mass Index; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D019266:Iron, Dietary / Q000008:administration & dosage; D018977:Micronutrients / Q000008:administration & dosage*; D009752:Nutritional Status; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena / Q000502:physiology*; D011340:Problem Solving / Q000187:drug effects* / Q000502:physiology; D011597:Psychomotor Performance / Q000187:drug effects* / Q000502:physiology; D013997:Time Factors
D019266:Iron, Dietary; D018977:Micronutrients; D005492:Folic Acid