Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial
<h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Christopher R. Sudfeld [verfasserIn] Lilia Bliznashka [verfasserIn] Aichatou Salifou [verfasserIn] Ousmane Guindo [verfasserIn] Issaka Soumana [verfasserIn] Irène Adehossi [verfasserIn] Céline Langendorf [verfasserIn] Rebecca F. Grais [verfasserIn] Sheila Isanaka [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2022 |
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| Übergeordnetes Werk: |
In: PLoS Medicine - Public Library of Science (PLoS), 2004, 19(2022), 5 |
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| Übergeordnetes Werk: |
volume:19 ; year:2022 ; number:5 |
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DOAJ032391811 |
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| 520 | |a <h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. | ||
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(DE-627)DOAJ032391811 (DE-599)DOAJeb945e86f2264c6396bfbd3bf1b614fc DE-627 ger DE-627 rakwb eng Christopher R. Sudfeld verfasserin aut Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. Medicine R Lilia Bliznashka verfasserin aut Aichatou Salifou verfasserin aut Ousmane Guindo verfasserin aut Issaka Soumana verfasserin aut Irène Adehossi verfasserin aut Céline Langendorf verfasserin aut Rebecca F. Grais verfasserin aut Sheila Isanaka verfasserin aut In PLoS Medicine Public Library of Science (PLoS), 2004 19(2022), 5 (DE-627)470151471 (DE-600)2164823-2 15491676 nnns volume:19 year:2022 number:5 https://doaj.org/article/eb945e86f2264c6396bfbd3bf1b614fc kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060361/?tool=EBI kostenfrei https://doaj.org/toc/1549-1277 Journal toc kostenfrei https://doaj.org/toc/1549-1676 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 5 |
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(DE-627)DOAJ032391811 (DE-599)DOAJeb945e86f2264c6396bfbd3bf1b614fc DE-627 ger DE-627 rakwb eng Christopher R. Sudfeld verfasserin aut Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. Medicine R Lilia Bliznashka verfasserin aut Aichatou Salifou verfasserin aut Ousmane Guindo verfasserin aut Issaka Soumana verfasserin aut Irène Adehossi verfasserin aut Céline Langendorf verfasserin aut Rebecca F. Grais verfasserin aut Sheila Isanaka verfasserin aut In PLoS Medicine Public Library of Science (PLoS), 2004 19(2022), 5 (DE-627)470151471 (DE-600)2164823-2 15491676 nnns volume:19 year:2022 number:5 https://doaj.org/article/eb945e86f2264c6396bfbd3bf1b614fc kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060361/?tool=EBI kostenfrei https://doaj.org/toc/1549-1277 Journal toc kostenfrei https://doaj.org/toc/1549-1676 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 5 |
| allfields_unstemmed |
(DE-627)DOAJ032391811 (DE-599)DOAJeb945e86f2264c6396bfbd3bf1b614fc DE-627 ger DE-627 rakwb eng Christopher R. Sudfeld verfasserin aut Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. Medicine R Lilia Bliznashka verfasserin aut Aichatou Salifou verfasserin aut Ousmane Guindo verfasserin aut Issaka Soumana verfasserin aut Irène Adehossi verfasserin aut Céline Langendorf verfasserin aut Rebecca F. Grais verfasserin aut Sheila Isanaka verfasserin aut In PLoS Medicine Public Library of Science (PLoS), 2004 19(2022), 5 (DE-627)470151471 (DE-600)2164823-2 15491676 nnns volume:19 year:2022 number:5 https://doaj.org/article/eb945e86f2264c6396bfbd3bf1b614fc kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060361/?tool=EBI kostenfrei https://doaj.org/toc/1549-1277 Journal toc kostenfrei https://doaj.org/toc/1549-1676 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 5 |
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(DE-627)DOAJ032391811 (DE-599)DOAJeb945e86f2264c6396bfbd3bf1b614fc DE-627 ger DE-627 rakwb eng Christopher R. Sudfeld verfasserin aut Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. Medicine R Lilia Bliznashka verfasserin aut Aichatou Salifou verfasserin aut Ousmane Guindo verfasserin aut Issaka Soumana verfasserin aut Irène Adehossi verfasserin aut Céline Langendorf verfasserin aut Rebecca F. Grais verfasserin aut Sheila Isanaka verfasserin aut In PLoS Medicine Public Library of Science (PLoS), 2004 19(2022), 5 (DE-627)470151471 (DE-600)2164823-2 15491676 nnns volume:19 year:2022 number:5 https://doaj.org/article/eb945e86f2264c6396bfbd3bf1b614fc kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060361/?tool=EBI kostenfrei https://doaj.org/toc/1549-1277 Journal toc kostenfrei https://doaj.org/toc/1549-1676 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 5 |
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(DE-627)DOAJ032391811 (DE-599)DOAJeb945e86f2264c6396bfbd3bf1b614fc DE-627 ger DE-627 rakwb eng Christopher R. Sudfeld verfasserin aut Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. Medicine R Lilia Bliznashka verfasserin aut Aichatou Salifou verfasserin aut Ousmane Guindo verfasserin aut Issaka Soumana verfasserin aut Irène Adehossi verfasserin aut Céline Langendorf verfasserin aut Rebecca F. Grais verfasserin aut Sheila Isanaka verfasserin aut In PLoS Medicine Public Library of Science (PLoS), 2004 19(2022), 5 (DE-627)470151471 (DE-600)2164823-2 15491676 nnns volume:19 year:2022 number:5 https://doaj.org/article/eb945e86f2264c6396bfbd3bf1b614fc kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060361/?tool=EBI kostenfrei https://doaj.org/toc/1549-1277 Journal toc kostenfrei https://doaj.org/toc/1549-1676 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 19 2022 5 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ032391811</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230307170021.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230226s2022 xx |||||o 00| ||eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ032391811</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJeb945e86f2264c6396bfbd3bf1b614fc</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Christopher R. Sudfeld</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2022</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a"><h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. 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Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial |
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Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial |
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Christopher R. Sudfeld Lilia Bliznashka Aichatou Salifou Ousmane Guindo Issaka Soumana Irène Adehossi Céline Langendorf Rebecca F. Grais Sheila Isanaka |
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evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural niger: a secondary analysis of a cluster randomized controlled trial |
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Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial |
| abstract |
<h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. |
| abstractGer |
<h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. |
| abstract_unstemmed |
<h4<Background</h4< It is estimated that over 250 million children under 5 years of age in low- and middle-income countries (LMICs) do not reach their full developmental potential. Poor maternal diet, anemia, and micronutrient deficiencies during pregnancy are associated with suboptimal neurodevelopmental outcomes in children. However, the effect of prenatal macronutrient and micronutrient supplementation on child development in LMIC settings remains unclear due to limited evidence from randomized trials. <h4<Methods and findings</h4< We conducted a 3-arm cluster-randomized trial (n = 53 clusters) that evaluated the efficacy of (1) prenatal multiple micronutrient supplementation (MMS; n = 18 clusters) and (2) lipid-based nutrient supplementation (LNS; n = 18 clusters) as compared to (3) routine iron–folic acid (IFA) supplementation (n = 17 clusters) among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019 (ClinicalTrials.gov identifier NCT02145000). Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. Nevertheless, the apparent beneficial effects of prenatal LNS were limited, and, therefore, integrated interventions that consider maternal and child nutritional support along with parenting interventions and other components to support an enabling environment may provide larger effects on child development outcomes. |
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Evaluation of multiple micronutrient supplementation and medium-quantity lipid-based nutrient supplementation in pregnancy on child development in rural Niger: A secondary analysis of a cluster randomized controlled trial |
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https://doaj.org/article/eb945e86f2264c6396bfbd3bf1b614fc https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9060361/?tool=EBI https://doaj.org/toc/1549-1277 https://doaj.org/toc/1549-1676 |
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Lilia Bliznashka Aichatou Salifou Ousmane Guindo Issaka Soumana Irène Adehossi Céline Langendorf Rebecca F. Grais Sheila Isanaka |
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Lilia Bliznashka Aichatou Salifou Ousmane Guindo Issaka Soumana Irène Adehossi Céline Langendorf Rebecca F. Grais Sheila Isanaka |
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Children were followed until 2 years of age, and the Bayley Scales of Infant and Toddler Development III (BSID-III) were administered to children every 3 months from 6 to 24 months of age. Maternal report of WHO gross motor milestone achievement was assessed monthly from 3 to 24 months of age. An intention-to-treat analysis was followed. Child BSID-III data were available for 559, 492, and 581 singleton children in the MMS, LNS, and IFA groups, respectively. Child WHO motor milestone data were available for 691, 781, and 753 singleton children in the MMS, LNS, and IFA groups, respectively. Prenatal MMS had no effect on child BSID-III cognitive (standardized mean difference [SMD]: 0.21; 95% CI: −0.20, 0.62; p = 0.32), language (SMD: 0.16; 95% CI: −0.30, 0.61; p = 0.50) or motor scores (SMD: 0.18; 95% CI: −0.39, 0.74; p = 0.54) or on time to achievement of the WHO gross motor milestones as compared to IFA. Prenatal LNS had no effect on child BSID-III cognitive (SMD: 0.17; 95% CI: −0.15, 0.49; p = 0.29), language (SMD: 0.11; 95% CI: −0.22, 0.44; p = 0.53) or motor scores (SMD: −0.04; 95% CI: −0.46, 0.37; p = 0.85) at the 24-month endline visit as compared to IFA. However, the trajectory of BSID-III cognitive scores during the first 2 years of life differed between the groups with children in the LNS group having higher cognitive scores at 18 and 21 months (approximately 0.35 SD) as compared to the IFA group (p-value for difference in trajectory <0.001). Children whose mothers received LNS also had earlier achievement of sitting alone (hazard ratio [HR]: 1.57; 95% CI: 1.10 to 2.24; p = 0.01) and walking alone (1.52; 95% CI: 1.14 to 2.03; p = 0.004) as compared to IFA, but there was no effect on time to achievement of other motor milestones. A limitation of our study is that we assessed child development up to 2 years of age, and, therefore, we may have not captured effects that are easier to detect or emerge at older ages. <h4<Conclusions</h4< There was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones. <h4<Trial registration</h4< ClinicalTrials.gov NCT02145000. Christopher R. Sudfeld and colleagues evaluate the benefit of multiple micronutrient supplementation and medium‐quantity lipid‐based nutrient supplementation in pregnancy on child development in rural Niger. Author summary <h4<Why was this study done?</h4< It is estimated that over 250 million children under 5 years of age do not reach their developmental potential in low- and middle-income country (LMIC) settings. Observational studies suggest that poor diet, anemia, and micronutrient deficiencies in pregnancy are associated with poor child development outcomes; however, the effect of macronutrient and micronutrient supplementation in pregnancy on child development outcomes remains inconclusive due to a limited number of randomized trials that have assessed developmental outcomes. <h4<What did the researchers do and find?</h4< We conducted a cluster-randomized controlled trial of prenatal multiple micronutrient supplementation (MMS) and lipid-based nutrient supplementation (LNS) as compared to routine iron–folic acid (IFA) supplementation among pregnant women in rural Niger and evaluated the effect on child development outcomes during the first 2 years of life. There was no benefit of prenatal MMS on child Bayley Scales of Infant and Toddler Development III (BSID-III) scores or on time to achievement of motor milestones as compared to IFA. There was no effect of prenatal LNS on BSID-III scores at 24 months of age as compared to IFA; however, the trajectory of child development differed between groups, with children in the prenatal LNS group having higher cognitive scores at 18 and 21 months of age as compared to IFA. Children whose mothers received prenatal LNS also had earlier achievement of sitting alone and walking alone as compared to children whose mothers received prenatal IFA. <h4<What do these findings mean?</h4< Prenatal supplementation with LNS appeared to support the achievement of selected motor milestones and improve cognitive development trajectory; however, there was no evidence of benefit of MMS over routine IFA on developmental outcomes in the context of rural Niger. 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|
| score |
7.39931 |