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Giving micronutrients to malnourished moms boosts cognition in kids

NEW YORK (Reuters Health) – Multiple micronutrient supplementation of undernourished Indonesian mothers prevents long-term cognitive delays in their children, a new study shows.

“This is a really important study for those working with mothers at risk of undernutrition or anemia,” Dr. Katherine J. Alcock from Lancaster University in the UK told Reuters Health by email. “It’s the children of those mothers who are at risk of delayed cognitive and motor development. What was particularly striking to us was how much we were able to improve children’s development — a few months’ advantage at the age of three is huge.”

Dr. Alcock and colleagues compared the effects of maternal supplementation with multiple micronutrients (MMNs) vs iron/folic acid (IFA) on motor and socioemotional skills, as well as several specific aspects of cognitive ability, as part of the Indonesian SUMMIT trial.

Children of mothers who received MMNs scored higher in motor development than did those of mothers who received IFA, but the difference was significant only in the adjusted analysis.

In children of undernourished mothers who received MMNs, the motor development scores were significantly higher than those of children of undernourished mothers who received IFA, a difference equivalent to about 4.5 months of age.

Similarly, children of undernourished mothers who received MMNs showed significantly higher visual attention/spatial ability than children of undernourished mothers who received IFA. This difference of about five months was not seen among children of mothers who were not undernourished during pregnancy.

Children of undernourished mothers who received MMNs had scores for both motor development and visual attention/spatial ability similar to children of mothers who were not undernourished in either supplement group, suggesting that maternal MMN supplementation protects against the negative developmental effects arising from the mother’s poor nutritional status during pregnancy.

Children of anemic mothers who received MMNs also showed about a three-month advantage over children of anemic mothers who received IFA in visual attention/spatial ability. This difference was not seen among children of mothers who were not anemic during pregnancy.

“Our team is investigating cognitive and developmental outcomes of MMN (rather than practicalities, health outcomes, etc.),” Dr. Alcock said. “We now have funding to look at the cognitive and educational outcomes of the same cohort of children aged 10 years, which is very exciting.”

“The brain develops so rapidly during pregnancy and infancy, making sure that sufficient nutrition is available for this growth to happen should be a global health priority,” co-author Dr. Elizabeth L. Prado told Reuters Health.

She continued, “Problems in laying the foundation of brain structure during this early period can have lifelong consequences for children’s cognitive ability, school performance, and productivity. We have shown benefits of multiple micronutrients provided during pregnancy up to 3.5 years later and we will soon find out if those benefits are sustained in children at age 8-11 years.”


Pediatrics 2012;130:e536-e546.