Effects of pre and post natal lipid based nutrient supplements on infant development in a randomized trial in Ghana.
BACKGROUND Maternal and infant undernutrition is negatively associated with infant development. AIMS We tested the hypothesis that provision of small quantity lipid based nutrient supplements (SQ LNS) to pregnant women and infants positively affects infant development. STUDY DESIGN In a partially double blind randomized controlled trial, we compared the following daily maternal supplements during pregnancy and until 6months post partum: iron/folic acid capsule (IFA) capsule containing 18 micronutrients (MMN) or 20g SQ LNS. Children in the SQ LNS group also received SQ LNS from age 6 to 18months. The study is registered as NCT00970866. SUBJECTS 1320 pregnant women in Ghana enrolled in the trial; 1173 of their children participated in developmental assessment. OUTCOME MEASURES We monitored the acquisition of 10 developmental milestones monthly by parental report, observed the attainment of 6 motor milestones at 6, 12, and 18months, and conducted detailed assessment of motor, language, socio emotional, and executive function at 18months. RESULTS By researcher observation, a greater percentage of children in the SQ LNS group (53% was able to walk alone at 12months than in the IFA group (43% RR=1.23, 95% CI=1.02 1.49; p=0.025) We found no significant differences between groups in milestone acquisition by parent report or in any scores at 18months. The difference in mean z scores between groups ranged from 0.03 0.13 for motor (p=0.84) 0.01 0.08 for language (p=0.46) 0.01 0.02 for socio emotional (p=0.75) and 0.00 0.02 for executive function (p=0.95) CONCLUSION While provision of maternal and child SQ LNS in Ghana may affect walking at 12months, it did not affect infant development at 18months.
Early human development