title: Supplemental feeding during pregnancy compared with maternal supplementation during lactation does not affect schooling and cognitive development through late adolescence.
abstract: BACKGROUND
  The long-term impact of early malnutrition on human capital outcomes remains unclear, and existing evidence has come largely from observational studies.
  
  
  OBJECTIVE
  We compared the impact of a nutritional supplement given during pregnancy or lactation in rural Gambia on educational performance and cognitive ability in offspring at their maturity.
  
  
  METHODS
  This study was a follow-up of a randomized trial of prenatal high protein and energy supplementation conducted between 1989 and 1994. Subjects were 16-22 y of age at follow-up, and information was collected on schooling achievement and cognitive ability by using the Raven's progressive matrices test, Mill Hill vocabulary test, and forward and backward digit-span tests.
  
  
  RESULTS
  A total of 1459 individuals were traced and interviewed and represented 71% of the original cohort and 81% of the surviving cohort. There was no difference in cognitive ability or educational attainment between treatment groups by using any of the methods of assessment.
  
  
  CONCLUSIONS
  We have shown little evidence to support a long-term effect of prenatal protein-energy supplementation compared with supplementation during lactation on cognitive development in rural Gambians. This trial was registered at http://www.controlled-trials.com as ISRCTN72582014.
authors.affiliation: Human Development Network, World Bank, Washington, DC (HA, ML, and AT); the International Food Policy Research Institute, Washington, DC (HA); the Medical Research Council (MRC), International Nutrition Group, London School of Hygiene and Tropical Medicine, London, United Kingdom; and the MRC Keneba, MRC Unit, Fajara, The Gambia (SH, HM, and SEM).
authors.forename: Harold
authors.initials: H
authors.lastname: Alderman
authors.forename: Sophie
authors.initials: S
authors.lastname: Hawkesworth
authors.forename: Mattias
authors.initials: M
authors.lastname: Lundberg
authors.forename: Afia
authors.initials: A
authors.lastname: Tasneem
authors.forename: Henry
authors.initials: H
authors.lastname: Mark
authors.forename: Sophie E
authors.initials: SE
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D001942:Breast Feeding; D002657:Child Development / Q000187:drug effects; D003071:Cognition / Q000187:drug effects*; D015331:Cohort Studies; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D005714:Gambia; D006801:Humans; D007223:Infant; D007774:Lactation / Q000187:drug effects*; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D011247:Pregnancy; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D004044:Dietary Proteins