Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T00:58:23.165Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental and psychomotor development in Indonesian infants of mothers supplemented with vitamin A in addition to iron during pregnancy

Published online by Cambridge University Press:  09 March 2007

Marjanka K. Schmidt ,
Siti Muslimatun ,
Clive E. West ,
Werner Schultink  and
Joseph G. A. J. Hautvast
Marjanka K. Schmidt
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands SEAMEO TROPMED Regional Centre for Community Nutrition, University of Indonesia, Jakarta, Indonesia
Siti Muslimatun
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands SEAMEO TROPMED Regional Centre for Community Nutrition, University of Indonesia, Jakarta, Indonesia
Clive E. West*
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands UNICEF, New York, USA
Werner Schultink
Affiliation:
Department of Gastroenterology, University Medical Centre Nijmegen, The Netherlands
Joseph G. A. J. Hautvast
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands
*
*Corresponding author: Professor Clive E. West, fax +31 317 483342, email Clive.West@wur.nl
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Maternal nutrition is important for fetal development, but its impact on the functional outcome of infants is still unclear. The present study investigated the effects of vitamin A and Fe supplementation during gestation on infant mental and psychomotor development. Mothers of infants from five villages in Indonesia were randomly assigned to supervised, double-blind supplementation once per week from approximately 18 weeks of pregnancy until delivery. Supplementation comprised 120 mg Fe + 500 μg folic acid with (n 94) or without (n 94) 4800 μg retinol in the form of retinyl acetate. Mothers of infants who participated in the national Fe+folic acid supplementation programme, but whose intake of supplements was not supervised, were recruited from four other villages (n 88). The mental and psychomotor development of infants was assessed, either at 6 or 12 months of age, using the Bayley Scales of Infant Development (BSID). We found no impact of vitamin A supplementation on mental or psychomotor development of infants. In addition, infants whose mothers had received weekly Fe supplementation had similar mental and psychomotor indices as those whose mothers had participated in the governmental Fe supplementation programme. The study population was moderately Fe and vitamin A deficient. The size of the treatment groups was large enough to detect a mean difference of 10 points on the BSID, which is less than 1 sd (15 points) of the average performance of an infant on the BSID. In conclusion, the present study did not find an impact of weekly supplementation of 4800 RE vitamin A in addition to Fe during gestation on functional development of Indonesian infants. However, smaller improvements in development may be seen if studied in a larger and/or more deficient population.

Keywords

Indonesian infantsMental and psychomotor developmentVitamin AIron
Type
Research Article
Information
British Journal of Nutrition , Volume 91 , Issue 2 , February 2004 , pp. 279 - 285
Copyright
Copyright © The Nutrition Society 2004

References

Adair, LS, Pollitt, E, (1985) Outcome of maternal nutritional supplementation: a comprehensive review of the Bacon Chow study. Am J Clin Nutr 41, 948–978.Google Scholar
Allen, LH, (2000) Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr 71, 1280S–1284S.CrossRefGoogle ScholarPubMed
Anderson, JW, Johnstone, BM & Remley, DT (1999) Breast-feeding and cognitive development: a meta-analysis. Am JClin Nutr 70, 525–535.Google Scholar
Antipatis, C, Grant, G & Ashworth, CJ (2000) Moderate maternal vitamin A deficiency affects perinatal organ growth and development in rats. Br J Nutr 84,125–132.CrossRefGoogle ScholarPubMed
Bayley, N (1969) Manual for the Bayley Scales of Development. New York: The Psychological Corporation.Google Scholar
Bayley, N (1993) Manual for the Bayley Scales of Development San Antonio, TX: The Psychological Corporation.Google Scholar
Chen, Q, Connor, JRBeard, JL, (1995) Brain iron transferrin and ferritin concentrations are altered in developing iron-deficient rats. J Nutr 125, 1529–1535.Google ScholarPubMed
Felt, BTLozoff, B (1996) Brain iron and behavior of rats are not normalized by treatment of iron deficiency anemia during early development. J Nutr 126, 693–701.CrossRefGoogle Scholar
Grantham-McGregor, SAni, C (2001) A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr 131, 649S–666S.CrossRefGoogle ScholarPubMed
Grantham-McGregor, S, Walker, SPChang, SM (2000) Nutritional deficiencies and later behavioral development. Proc Nutr Soc 59, 47–54.Google Scholar
Hamadani, JD, Fuchs, GJ, Osendarp, SJ et al. (2001) Randomized controlled trial of the effect of zinc supplementation on the mental development of Bangladeshi infants. Am J Clin Nutr 74, 381–386.Google Scholar
Hassard, TH (1991) Understanding Biostatistics. St Louis, MO: Mosby.Google Scholar
Humphrey, JH, Agoestina, T & Juliana, A (1998) Neonatal vitamin A supplementation: effect on development and growth at 3y of age. Am J Clin Nutr 68, 109–117.CrossRefGoogle Scholar
Husaini, MA, Karyadi, L, Husaini, YK et al. (1991) Developmental effects of short-term supplementary feeding in nutritionally-at-risk Indonesian infants. Am J Clin Nutr 54, 799–804.Google Scholar
Idjradinata, PPollitt, E (1993) Reversal of developmental delays in iron-deficient anaemic (1993)Reversal of developmental delays in iron-deficient anaemic infants treated with iron. Lancet 341, 1–4.CrossRefGoogle ScholarPubMed
Jeliffe, DB (1996) The Assessment of the Nutritional Status of the Community. WHO Monograph Series, no. 53. GenevaWHO.Google Scholar
Levitsky, DA & Strupp, BJ (1995) Malnutrition and the brain: changing concepts, changing concerns. J Nutr 125, 2212S–2220S.Google Scholar
Lozoff, B, Brittenham, GM, Viteri, FE, Wolf, AW & Urrutia, JJ (1982) The effects of short-term oral iron therapy on developmental deficits in iron-deficient anemic infants. J Pediatr 100, 351–357.CrossRefGoogle Scholar
Lozoff, B, Jimenez, E & Wolf, AW (1991) Long-term developmental outcome of infants with iron deficiency. New Engl J Med 325, 687–694.CrossRefGoogle ScholarPubMed
Maden, M (2000) The role of retinoic acid in embryonic and post-embryonic development. Proc Nutr Soc 59, 65–73.CrossRefGoogle ScholarPubMed
Muslimatun, S, Schmidt, MK, Schultink, W et al. (2001 a) Weekly supplementation with iron and vitamin A during pregnancy increases hemoglobin concentration but decreases serum ferritin concentration in Indonesian pregnant women. J Nutr 131, 85–90.CrossRefGoogle ScholarPubMed
Muslimatun, S, Schmidt, MK, West, CE et al. (2001 b) Weekly vitamin A and iron supplementation during pregnancy increases vitamin A concentration of breast milk but not iron status in Indonesian lactating women. J Nutr 131, 2664–2669.CrossRefGoogle Scholar
Nokes, CVan den Bosch, C & Bundy, DAP (1998) The effects of iron deficiency and anemia on mental and motor performance educational achievement and behavior in children. A Report of The International Nutritional Anemia Consultative Group. Washington, DC: International Life Science Institute.Google Scholar
Ortega, RM, Andres, P, Martinez, RMLopez-Sobaler, AM (1997), Vitamin A status during the third trimester of pregnancy in Spanish women: influence on concentrations of vitamin A in breast milk. Am J Clin Nutr 66, 564–568.Google Scholar
Pollitt, E (2001) Statistical and psychobiological significance in developmental research. Am J Clin Nutr 74, 281–282.Google Scholar
Pollitt, E, Watkins, WE & Husaini, MA (1997) Three-month nutritional supplementation in Indonesian infants and toddlers benefits memory function 8y later. Am J Clin Nutr 66, 1357–1363.CrossRefGoogle Scholar
Ramakrishnan, U, Manjrekar, R, Rivera, J, Gonzales, CT & Martorell, R (1999) Micronutrients and pregnancy outcome: A review of the literature. Nutr Res 19, 103–159.Google Scholar
Schmidt, MK, Muslimatun, S, Schultink, W, West, CE & Hautvast, JGAJ (2002) Randomised double-blind trial of the effect of vitamin A supplementation of Indonesian pregnant women on morbidity and growth of their infants during the first year of life. Eur J Clin Nutr 56, 338–346.CrossRefGoogle ScholarPubMed
Schmidt, MK, Muslimatun, S, West, CE, Schultink, W & Hautvast, JGAJ (2001) Vitamin A and iron supplementation of Indonesian pregnant women benefits vitamin A status of their infants. Br J Nutr 86, 607–615.CrossRefGoogle ScholarPubMed
Scholl, TO & Hediger, ML (1994) Anemia and iron-deficiency anemia: compilation of data on pregnancy outcome. Am J Clin Nutr 59, 492S–500S.Google Scholar
Schultink, JW & Gross, R (1996) Iron deficiency alleviation in developing countries. Nutr Res Rev 9, 281–293.CrossRefGoogle ScholarPubMed
Siimes, MA, Salmenpera, L & Perheentupa, J (1984) Exclusive breast-feeding for 9 months: risk of iron deficiency. J Pediatr 104, 196–199.CrossRefGoogle ScholarPubMed
Suharno, D, West, CE, Muhilal, , Karyadi, D & Hautvast, JG (1993) Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java Indonesia. Lancet 342, 1325–1328.Google Scholar
Underwood, BA (1994) Maternal vitamin A status and its importance in infancy and early childhood. Am J Clin Nutr 59, 517S–522S.Google Scholar
United Nations Administrative Committee on Coordination/Sub-committee on Nutrition (2000) Fourth Report on the World Nutrition Situation. Nutrition Throughout the Life Cycle. Geneva: ACC/SCN in collaboration with IFPRI.Google Scholar
Wauben, IP & Wainwright, PE (1999) The influence of neonatal nutrition on behavioral development: a critical appraisal. Nutr Rev 57, 35–44.CrossRefGoogle ScholarPubMed
Yip, R (2000) Significance of an abnormally low or high hemoglobin concentration during pregnancy: special consideration of iron nutrition. Am J Clin Nutr 72, 272S–278S.CrossRefGoogle ScholarPubMed
Zile, MH (2001) Function of vitamin A in vertebrate embryonic development. J Nutr 131, 705–708.CrossRefGoogle ScholarPubMed