RT Journal Article
SR Electronic
T1 Neurodevelopment, vision and auditory outcomes at age 2 years in offspring of participants in the ‘Women First’ maternal preconception nutrition randomised controlled trial
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 622
OP 631
DO 10.1136/archdischild-2023-325352
VO 108
IS 8
A1 Michelle Fernandes
A1 Nancy F Krebs
A1 Jamie Westcott
A1 Antoinette Tshefu
A1 Adrien Lokangaka
A1 Melissa Bauserman
A1 Ana L Garcés
A1 Lester Figueroa
A1 Sarah Saleem
A1 Sumera A Aziz
A1 Robert L Goldenberg
A1 Shivaprasad S Goudar
A1 Sangappa M Dhaded
A1 Richard J Derman
A1 Jennifer F Kemp
A1 Marion Koso-Thomas
A1 Amaanti Sridhar
A1 Elizabeth M McClure
A1 K Michael Hambidge
A1 ,
YR 2023
UL http://adc.bmj.com/content/108/8/622.abstract
AB Background Maternal nutrition in preconception and early pregnancy influences fetal growth. Evidence for effects of prenatal maternal nutrition on early child development (ECD) in low-income and middle-income countries is limited.Objectives To examine impact of maternal nutrition supplementation initiated prior to or during pregnancy on ECD, and to examine potential association of postnatal growth with ECD domains.Design Secondary analysis regarding the offspring of participants of a maternal multicountry, individually randomised trial.Setting Rural Democratic Republic of the Congo, Guatemala, India and Pakistan.Participants 667 offspring of Women First trial participants, aged 24 months.Intervention Maternal lipid-based nutrient supplement initiated preconceptionally (arm 1, n=217), 12 weeks gestation (arm 2, n=230) or not (arm 3, n=220); intervention stopped at delivery.Main outcome measures The INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) cognitive, language, gross motor, fine motor, positive and negative behaviour scores; visual acuity and contrast sensitivity scores and auditory evoked response potentials (ERP). Anthropometric z-scores, family care indicators (FCI) and sociodemographic variables were examined as covariates.Results No significant differences were detected among the intervention arms for any INTER-NDA scores across domains, vision scores or ERP potentials. After adjusting for covariates, length-for-age z-score at 24 months (LAZ24), socio-economic status, maternal education and FCI significantly predicted vision and INTER-NDA scores (R2=0.11–0.38, p<0.01).Conclusions Prenatal maternal nutrition supplementation was not associated with any neurodevelopmental outcomes at age 2 years. Maternal education, family environment and LAZ24 predicted ECD. Interventions addressing multiple components of the nurturing care model may offer greatest impact on children’s developmental potential.Trial registration number NCT01883193.Data are available on reasonable request. On publication of study findings, de-identified study data will be available through the NICHD Data and Specimen Hub (N-DASH) at https://dash.nichd.nih.gov.