Published online March 30, 2009
PEDIATRICS Vol. 123 No. 4 April 2009, pp. e685-e692 (doi:10.1542/peds.2008-3007)
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ARTICLE

Effects of Maternal Multimicronutrient Supplementation on the Mental Development of Infants in Rural Western China: Follow-up Evaluation of a Double-Blind, Randomized, Controlled Trial

Qiang Li, MSca,b, Hong Yan, MSca, Lingxia Zeng, MSca, Yue Cheng, MSca, Weifeng Liang, MSca, Shaonong Dang, PhDa, Quanli Wang, MSca and Ichiro Tsuji, MD, PhDb

a Division of Epidemiology and Biostatistics, Department of Public Health, Xi'an Jiaotong University School of Medicine, Xi'an, China
b Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan

OBJECTIVE. We investigated the benefits of maternal multimicronutrient supplementation during gestation on the mental and psychomotor development of infants.

METHODS. In a double-blind, randomized, controlled trial, pregnant women (N = 5828) in 2 rural counties in western China were assigned randomly to receive multimicronutrient (5 minerals and 10 vitamins at levels approximating the recommended daily allowance), folic acid plus iron, or folic acid supplementation daily from ~14 weeks of gestation until delivery. We assessed a subset of the newborns (N = 1305) from the 3 supplementation groups by measuring their mental and psychomotor development with the Bayley Scales of Infant Development, at 3, 6, and 12 months of age. Multilevel analyses were used to compare the mental development and psychomotor development raw scores at 3, 6, and 12 months.

RESULTS. Multimicronutrient supplementation was associated with mean increases in mental development raw scores for infants at 1 year of age of 1.00 and 1.22 points, compared with folic acid only and folic acid plus iron supplementation, respectively. However, supplementation did not increase significantly the psychomotor development raw scores up to 1 year of age.

CONCLUSION. Compared with iron and folic acid supplementation, the administration of multimicronutrients to pregnant women improved the mental development of their children at 1 year of age.

Key Words: multimicronutrients • dietary supplements • pregnancy • infants • Bayley Scales of Infant Development • randomized • controlled trial

Abbreviations: MD—mental development • BSID—Bayley Scales of Infant Development • PD—psychomotor development • CI—confidence interval

Accepted Dec 22, 2008.


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