Indonesia mother, child

Studies explore micronutrients’ effects in pregnant women and their children

August 23, 2012 — Micronutrients like vitamin B6, zinc, and iodine, when given to pregnant women, significantly improve their cognitive ability and boost their children’s motor and cognitive skills, according to two new studies by scientists at the Harvard School of Public Health (HSPH), the SUMMIT Institute of Development (SID), University of Mataram in Indonesia, Georgetown University, and Lancaster University in the UK. The studies also show that micronutrients’ positive effects are even more pronounced in pregnant women who are either undernourished or anemic.

Cognitive benefits for young children

In a study on the effects of maternal micronutrient supplements on children, published in Pediatrics on August 20, 2012, the researchers examined cognitive differences between two groups of three-and-a-half-year-olds whose mothers had received either multiple micronutrients (MMNs) or iron and folic acid (IFA) supplements while they were pregnant. The MMNs included vitamins D and E, retinol, ascorbic acid, niacin, zinc, copper, selenium, iodine, and four kinds of B vitamins, including vitamin B6. The study was a three-year follow-up of children from the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT), a randomized trial including more than 32,000 Indonesian women that compared the effects of maternal MMN supplementation to those taking IFA supplements, which are routinely recommended for pregnant women.

Read the Pediatrics abstract

The researchers found that MMNs had a significant positive effect in children whose mothers were either undernourished or anemic during pregnancy. In children of undernourished mothers who’d been given MMNs, motor development was improved. This group of children, as well as the group whose mothers had been anemic during pregnancy and received MMNs, also showed advantages in visual attention and spatial ability.

These results demonstrate the importance of micronutrients for intact brain development, the authors said, and underscore these supplements’ particular importance in low- and middle-income countries, where lagging development in early childhood is a critical problem. Anuraj Shankar, senior author of the study and senior research scientist in the Department of Nutrition, and lead author Beth Prado of SID emphasized that the study indicates the crucial role and long-term impact on child development of maternal supplementation with micronutrients beyond iron and folic acid alone.

Improved cognition for pregnant women

Shankar and Prado and colleagues also co-authored a study published online March 12, 2012 in PLoS ONE, again based on data from the SUMMIT trial, that examined cognition, motor dexterity, and mood among 640 pregnant women who took either MMN or IFA supplements during pregnancy.

Women who took MMN supplements scored higher than the women who took IFA supplements on every cognitive and motor test, particularly in terms of reading efficiency. In fact, the benefit on overall cognitive performance was roughly equivalent to the benefit of one year of primary school education for all mothers; to two years of education for anemic mothers; and to three years of education for undernourished mothers.

Read the PLoS article

Given that previous studies have indicated that higher maternal education and capability reduces the risk of mortality and malnutrition in infants, as well as sickness and poor growth in children, the authors note that MMN supplements could play a crucial role in improving women’s care for their infants—and thus improve infant health and survival rates. Said lead author Prado, “The mothers’ improved cognition highlights an under-recognized pathway whereby maternal nutrition can influence her health and the health and development of her children.”

To further explore these findings, the research team—including Shankar, Prado, Husni Muadz of the University of Mataram, Susy Sebayang, Mandri Apriatni and Ben Harefa of SID, Michael Ullman from Georgetown University, and Katie Alcock from Lancaster University—are currently conducting a ten-year follow-up of all mothers and children from the SUMMIT study to determine the long-term effect of MMNs on maternal and child health, cognition, and childhood school performance.

–Karen Feldscher

Photo: REUTERS/Beawiharta Beawiharta