Effect of Maternal Multivitamin Supplementation on the Mental and Psychomotor Development of Children Who Are Born to HIV-1–Infected Mothers in Tanzania Effect of Iron Deficiency Anemia in Pregnancy on Child Mental Development in Rural China Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Early Predictors of Adolescent Aggression and Adult Violence Effects of prenatal multiple micronutrient supplementation on growth and cognition through 2 y of age in rural Bangladesh: the JiVitA-3 Trial. Omega-3 Fatty Acid Deficiency in Infants before Birth Identified Using a Randomized Trial of Maternal DHA Supplementation in Pregnancy Effect of iron supplementation during pregnancy on the intelligence quotient and behavior of children at 4 y of age: long-term follow-up of a randomized controlled trial. Effect of zinc supplementation of pregnant women on the mental and psychomotor development of their children at 5 y of age. Maternal consumption of a docosahexaenoic acid-containing functional food during pregnancy: benefit for infant performance on problem-solving but not on recognition memory tasks at age 9 mo. Effects of prenatal food and micronutrient supplementation on infant development: a randomized trial from the Maternal and Infant Nutrition Interventions, Matlab (MINIMat) study. Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. Mental and psychomotor development in Indonesian infants of mothers supplemented with vitamin A in addition to iron during pregnancy. The Effect of Maternal Multiple Micronutrient Supplementation on Cognition and Mood during Pregnancy and Postpartum in Indonesia: A Randomized Trial The Effect of Intermittent Antenatal Iron Supplementation on Maternal and Infant Outcomes in Rural Viet Nam: A Cluster Randomised Trial The effect of iodine supplementation in pregnancy on early childhood neurodevelopment and clinical outcomes: results of an aborted randomised placebo-controlled trial Cognitive assessment of children at age 2½ years after maternal fish oil supplementation in pregnancy: a randomised controlled trial Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study Supplementation of fish-oil and soy-oil during pregnancy and psychomotor development of infants. Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal. Prenatal supplementation with DHA improves attention at 5 y of age: a randomized controlled trial. Randomized controlled trial of maternal omega-3 long-chain PUFA supplementation during pregnancy and early childhood development of attention, working memory, and inhibitory control. No-go dominant brain activity in human inferior prefrontal cortex revealed by functional magnetic resonance imaging. Infant neurocognitive development is independent of the use of iodised salt or iodine supplements given during pregnancy. Zinc supplementation during pregnancy and effects on mental development and behaviour of infants: a follow-up study Effects of maternal vitamin B12 supplementation on early infant neurocognitive outcomes: a randomized controlled clinical trial 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 Folate and long-chain polyunsaturated fatty acid supplementation during pregnancy has long-term effects on the attention system of 8.5-y-old offspring: a randomized controlled trial. The Bacon Chow study: maternal nutritional supplementation and infant behavioral development. The performance of human infants on a measure of frontal cortex function, the delayed response task. Nutritional supplementation and the outcome of pregnancy. II. Visual habituation at 15 days. Nutritional supplementation, maternal education, and cognitive development of infants at risk of malnutrition. Phosphatidylcholine supplementation in pregnant women consuming moderate-choline diets does not enhance infant cognitive function: a randomized, double-blind, placebo-controlled trial. Maternal DHA and the development of attention in infancy and toddlerhood. Effect of Supplementing Pregnant and Lactating Mothers With n-3 Very-Long-Chain Fatty Acids on Children's IQ and Body Mass Index at 7 Years of Age
OBJECTIVES . To determine the association between maternal multivitamin supplementation and the mental and psychomotor development of children who are born to HIV-1–infected mothers in Tanzania , as secondary endpoints in a r and omized trial that investigated the effect of maternal multivitamin supplementation on HIV-1 vertical transmission and progression . METHODS . The Bayley Scales of Infant Development , 2nd Edition , were administered at 6 , 12 , and 18 months of age to a subset of children ( N = 327 ) . We assessed the effect of vitamin A and multivitamin ( vitamins B , C , and E ) supplementation using linear regression models and Cox proportional hazard models for the Mental Development Index , the Psychomotor Development Index , and raw scores separately . RESULTS . Multivitamin supplementation was associated significantly with a mean increase in Psychomotor Development Index score of 2.6 ( 95 % confidence interval : 0.1–5.1 ) . Multivitamins were also significantly protective against the risk for developmental delay on the motor scale ( relative risk : 0.4 ; 95 % confidence interval : 0.2–0.7 ) but not on the Mental Development Index .  Vitamin A supplementation had no significant effect on these outcomes . CONCLUSIONS . Maternal multivitamin supplements provide a low-cost intervention to reduce the risk for developmental delays among infants who are born to HIV-positive mothers in developing countries OBJECTIVE : To determine the impact of iron deficiency anemia ( IDA ) in pregnancy on young child development . METHODS : A 2-year follow-up of 850 children born to women who participated in a double-blind cluster r and omized controlled trial of prenatal micronutrient supplementation in western rural China . These women were r and omly assigned to receive either daily folic acid , iron/folic acid ( 60 mg iron ) , or multiple micronutrients ( with 30 mg iron ) during pregnancy . Children were categorized into the prenatal-IDA and prenatal – non-IDA groups based on the mother ’s hemoglobin in the third trimester . Each group contained 3 subgroups based on mother ’s treatment : folic acid , iron/folic acid , and multiple micronutrients .  Bayley scales of infant development were administered to the children to assess their development at 3 , 6 , 12 , 18 , and 24 months of age . RESULTS : Compared with the prenatal – non-IDA group , the prenatal-IDA group showed a significantly lower mental development index at 12 , 18 , and 24 months of age . The adjusted mean difference was 5.8 ( 95 % confidence interval [ CI ] , 1.1–10.5 ) , 5.1 ( 95 % CI , 1.2–9.0 ) , and 5.3 ( 95 % CI , 0.9–9.7 ) , respectively . Further analysis showed that the mental development indexes in the prenatal-IDA group and prenatal – non-IDA group were similar with supplementation of iron/folic acid but were significantly lower in the prenatal-IDA group with supplementation of folic acid or multiple micronutrients . CONCLUSIONS : Prenatal IDA in the third trimester is associated with mental development of the child . However , prenatal supplementation with sufficient iron protects child development even when the woman ’s IDA was not properly corrected in pregnancy CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 OBJECTIVES Docosahexaenoic acid ( DHA ; 22:6 n-3 ) and arachidonic acid ( AA ; 20:4 n-6 ) are important for development of the central nervous system in mammals . There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months , with a large increase in the cerebral content of AA and DHA .  The fetus and the newborn infant depend on maternal supply of DHA and AA . Our hypothesis was that maternal intake of DHA during pregnancy and lactation is marginal and that high intake of this fatty acid would benefit the child . We examined the effect of supplementing pregnant and lactating women with very-long-chain n-3 polyunsaturated fatty acids ( PUFAs ; cod liver oil ) on mental development of the children , compared with maternal supplementation with long-chain n-6 PUFAs ( corn oil ) . METHODS The study was r and omized and double-blinded . Pregnant women were recruited in week 18 of pregnancy to take 10 mL of cod liver oil or corn oil until 3 months after delivery . The cod liver oil contained 1183 mg/10 mL DHA , 803 mg/10 mL eicosapentaenoic acid ( 20:5 n-3 ) , and a total of 2494 mg/10 mL summation operator n-3 PUFAs . The corn oil contained 4747 mg/10 mL linoleic acid ( 18:2 n-6 ) and 92 mg/10 mL alpha-linolenic acid ( 18:3 n-3 ) . The amount of fat-soluble vitamins was identical in the 2 oils ( 117 micro g/mL vitamin A , 1 micro g/mL vitamin D , and 1.4 mg/mL dl-alpha-tocopherol ) . A total of 590 pregnant women were recruited to the study , and 341 mothers took part in the study until giving birth . All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age , and 262 complied with the request . As part of the protocol , 135 subjects from this population were invited for intelligence testing  with the Kaufman Assessment Battery for Children ( K-ABC ) at 4 years of age . Of the 135 invited children , 90 came for assessment . Six children did not complete the examination . The K-ABC is a measure of intelligence and achievement design ed for children aged 2.5 years through 12.5 years . This multisubtest battery comprises 4 scales : Sequential Processing , Simultaneous Processing , Achievement ( not used in the present study ) , and Nonverbal Abilities . The Sequential Processing and Simultaneous Processing scales are hypothesized to reflect the child 's style of problem solving and information processing . Scores from these 2 scales are combined to form a Mental Processing Composite , which serves as the measure of intelligence in the K-ABC . RESULTS We received dietary information from 76 infants ( 41 in the cod liver oil group and 35 in the corn oil group ) , documenting that all of them were breastfed at 3 months of age . Children who were born to mothers who had taken cod liver oil ( n = 48 ) during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken  corn oil  ( n = 36 ; 106.4 [ 7.4 ] vs 102.3 [ 11.3 ] ) . The Mental Processing Composite score correlated significantly with head circumference at birth ( r = 0.23 ) , but no relation was found with birth weight or gestational length . The children 's mental processing scores at 4 years of age correlated significantly with maternal intake of DHA and eicosapentaenoic acid during pregnancy . In a multiple regression model , maternal intake of DHA during pregnancy was the only variable of statistical significance for the children 's mental processing scores at 4 years of age . CONCLUSION Maternal intake of very-long-chain n-3 PUFAs during pregnancy and lactation may be favorable for later mental development of children The Cambridge Study in Delinquent Development is a prospect i ve longitudinal survey of 411 London males from ages 8 years old to 32 years old . This article investigates the prediction of  adolescent aggression  ( ages 12 - 14 years old ) ,  teenage violence  ( ages 16 - 18 years old ) ,  adult violence  ( age 32 years old ) , and  convictions for violence .  Generally , the best predictors were measures of economic deprivation , family criminality , poor child-rearing , school failure , hyperactivity-impulsivity-attention deficit , and antisocial child behavior . Similar predictors applied to all four measures of aggression and violence . It is concluded that aggression and violence are elements of a more general antisocial tendency , and that the predictors of aggression and violence are similar to the predictors of antisocial and criminal behavior in general BACKGROUND Childhood undernutrition may have prenatal origins , and the impact of prenatal interventions on postnatal growth is not well known . OBJECTIVE We assessed the effects of prenatal multiple micronutrient ( MM ) supplementation on child growth and cognitive development . DESIGN In a cluster-r and omized controlled trial in rural Bangladesh , prenatal MM supplementation compared with iron-folic acid ( IFA ) supplementation was examined for its impact on growth assessed longitudinally from birth up to 24 mo of age ( n = 8529 ) and , in a sub sample ( n = 734 ) , on cognitive function at 24 mo of age by use of the Bayley scales of infant and toddler development-third edition test . RESULTS Prevalence of stunting at birth [ length for age z score ( LAZ ) : < -2 ] was 31.9 % in the MM and 35.7 % in the IFA groups ( P < 0.001 ) ; however , LAZ increased during the first 3 - 4 mo in both groups . With the use of a linear r and om-effects model , prenatal MM-exposed children sustained a higher mean predicted LAZ of ∼0.10 at 1 and 3 mo and 0.06 at 6 mo of age compared with children in the IFA group . Supplementation reduced the prevalence of stunting at 1 ( RR : 0.95 ; 95 % CI : 0.92 , 0.98 ) and 3 ( RR : 0.91 ; 95 % CI : 0.88 , 0.94 ) mo of age . Differences between groups were absent by 6 , 12 , and 24 mo of age , when nearly 50 % of children had stunted growth . Ponderal and linear growth velocities were somewhat slower from 3 to 12 mo of age in the MM group than in the IFA group , but not from 12 to 24 mo of age . There was no difference between groups on composite scores of cognition , language , and motor performance at 24 mo of age . CONCLUSIONS In this Bangladeshi trial , maternal pre- and postnatal MM supplementation result ed in improvements in LAZ and reduction in stunting through 3 mo of age , but not thereafter and had no impact on cognitive and motor function at 2 y. This trial was registered at clinical trials.gov as NCT000860470 Background DHA is accumulated in the central nervous system ( CNS ) before birth and is involved in early developmental processes , such as neurite outgrowth and gene expression . Objective To determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants . Design A risk reduction model using a r and omized prospect i ve study of term gestation single birth healthy infants born to women ( n = 270 ) given a placebo or 400 mg/day DHA from 16 wk gestation to delivery . Fetal DHA deficiency sufficient to constrain CNS development was assessed based on increased risk that infants in the placebo group would not achieve neurodevelopment scores in the top quartile of all infants in the study . Results Infants in the placebo group were at increased risk of lower language development assessed as words understood ( OR 3.22 , CL 1.49–6.94 , P = 0.002 ) and produced ( OR 2.61 , CL 1.22–5.58 , P = 0.01 ) at 14 mo , and words understood ( OR 2.77 , CL 1.23–6.28 , P = 0.03 ) and sentences produced ( OR 2.60 , CL 1.15–5.89 , P = 0.02 ) at 18 mo using the McArthur Communicative Developmental Inventory ; receptive ( OR 2.23 , CL 1.08–4.60 , P = 0.02 ) and expressive language ( OR 1.89 , CL 0.94–3.83 , P = 0.05 ) at 18 mo using the Bayley Scales of Infant Development III ; and visual acuity ( OR 2.69 , CL 1.10–6.54 , P = 0.03 ) at 2 mo . Trial Registration Clinical Trials.gov BACKGROUND Iron supplements are often prescribed during pregnancy despite the lack of intervention trials that have assessed the effects of supplementation in pregnancy on childhood development . OBJECTIVE The objective was to determine whether iron supplementation during pregnancy influences  childhood intelligence quotient ( IQ )  in an industrialized country . DESIGN Pregnant women ( n = 430 ) were r and omly allocated to receive iron ( 20 mg/d ) or placebo from 20 wk gestation until delivery , and the women and their children were followed up over the long term ( 4 y ) . Seventy percent of these families participated in the follow-up . The proportion of women with iron deficiency anemia at the end of pregnancy was 1 % ( 2 of 146 ) in the iron group and 11 % ( 15 of 141 ) in the placebo group . The primary outcome was the IQ of the children at 4 y of age , as assessed by the Stanford-Binet Intelligence Scale . Secondary outcomes included child behavior and the general health of the mothers . RESULTS The mean IQ was not significantly different ( P = 0.980 ) between the children of the iron-supplemented mothers ( 109 + /- 11 ; n = 153 ) and the children of the mothers in the placebo group ( 109 + /- 11 ; n = 149 ) . However , the percentage of children with an abnormal behavior score was higher in the iron group ( 24 of 151 , or 16 % ) than in the placebo group ( 12 of 149 , or 8 % ) ; the relative risk was 1.97 ( 95 % CI : 1.03 , 3.80 ; P = 0.037 ) . There was no significant difference in the health of the mothers between groups , as assessed by the SF-36 Health Survey . CONCLUSIONS Prenatal iron supplementation that reduces the incidence of iron deficiency anemia from 11 % to 1 % has no effect on the IQ of the offspring at 4 y of age BACKGROUND A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals , but this association in humans is controversial . OBJECTIVE We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that result ed in increased head circumference and birth weight .  DESIGN The children took 6 tests-the Differential Ability Scales , Visual Sequential Memory , Auditory Sequential Memory , Knox Cube , Gross Motor Scale , and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo . RESULTS There were no differences in the test scores of neurologic development between the 2 groups . We analyzed the scores in 4 subgroups on the basis of maternal body mass index , because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index ( in kg/m(2 ) ) < 26.0 in the original trial . No differences in the scores were found between these subgroups . CONCLUSIONS Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other population BACKGROUND There are few studies reporting on docosahexaenoic acid ( DHA , 22:6n-3 ) supplementation during pregnancy and infant cognitive function . DHA supplementation in pregnancy and infant problem solving in the first year have not been investigated . OBJECTIVE We tested the hypothesis that infants born to women who consumed a DHA-containing functional food during pregnancy would demonstrate better problem-solving abilities and recognition memory than would infants born to women who consumed the placebo during pregnancy . DESIGN In a double-blind , placebo-controlled , r and omized trial , pregnant women consumed a DHA-containing functional food or a placebo from gestation week 24 until delivery . Study groups received DHA-containing cereal-based bars ( 300 mg DHA/92-kcal bar ; average consumption : 5 bars/wk ; n = 14 ) or cereal-based placebo bars ( n = 15 ) . The Infant Planning Test and Fagan Test of Infant Intelligence were administered to infants at age 9 mo . The problem-solving trial included a support step and a search step . The procedure was scored on the basis of the infant 's performance on each step and on the entire problem ( intention score and total intentional solutions ) . Scores were generated on the basis of the cumulative performance of the infant on 5 trials . RESULTS Treatment had significant effects on the performance of problem-solving tasks : total intention score ( P = 0.017 ) , total intentional solutions ( P = 0.011 ) , and number of intentional solutions on both cloth ( P = 0.008 ) and cover ( P = 0.004 ) steps . There were no significant differences between groups in any measure of Fagan Test of Infant Intelligence . CONCLUSION These data point to a benefit for problem solving but not for recognition memory at age 9 mo in infants of mothers who consumed a DHA-containing functional food during pregnancy BACKGROUND Few data exist for the effects of multiple micronutrient ( MM ) or food supplementation to undernourished pregnant women on their offsprings ' development . OBJECTIVE We aim ed to compare the effects on infant development of early ( 8 - 10 wk gestation ) or usual ( approximately 17 wk gestation ) supplementation with food and MM , 30 mg Fe + 400 microg folate , or 60 mg Fe + 400 microg folate . DESIGN A large , r and omized , controlled trial of pregnancy supplementation was conducted in Bangladesh . A sub sample of infants ( n = 2853 ) were assessed on 2 problem-solving tests ( support and cover tests ) , the motor index of the Bayley Scales of Infant Development , and Wolke 's behavior ratings at 7 mo of age . RESULTS There were no significant effects of any intervention in the group as a whole . However , infants of undernourished mothers [ body mass index ( BMI ; in kg/m2 ) < 18.5 ] who received early food supplementation performed slightly but significantly ( P = 0.035 ) better on the support test than did infants of mothers who received usual food supplementation ( z score : 0.17 ; 95 % CI : 0.01 , 0.33 ) . There were no benefits in infants of higher- BMI mothers ( P = 0.024 for BMI x food interaction ) . Children of low- BMI mothers who received MMs had slightly better motor scores ( z score : 0.28 ; 95 % CI : 0.08 , 0.48 ) and activity ratings ( z score : 0.24 ; 95 % CI : 0.037 , 0.45 ) than did those who received 30 mg Fe + 400 microg folate , whereas other children did not benefit ( P = 0.05 for both motor scores and BMI x micronutrients and for activity and BMI x micronutrients ) . CONCLUSIONS Small benefits from early food and MM supplementation were found in infants of low- BMI but not of high- BMI mothers . However , the benefits were of doubtful functional importance , and longer follow-up is required to determine programmatic implication OBJECTIVE There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids ( PUFAs ) during pregnancy may increase birth weight and gestational length . In addition , n-3 long-chain PUFAs may be important for the neurobiological development of the infants . High levels of docosahexaenoic acid ( DHA , 22:6 n-3 ) are found in the gray matter of the cerebral cortex and in the retina , and it seems as if the availability of long-chain PUFAs may be limiting cerebral development . The fetus and the newborn are dependent on a high supply from their mothers , either via the placenta or via breast milk . We supplemented pregnant and lactating women with n-3 or n-6 long-chain PUFAs to evaluate the effect on birth weight , gestational length , and infant development . DESIGN We performed a double-blind , r and omized study recruiting 590 pregnant , healthy , nulli- or primiparous women ( 19 - 35 years old ) in weeks 17 to 19 of pregnancy . The women were provided 10 mL of either cod liver oil or corn oil daily until 3 months after delivery . MAIN OUTCOME MEASURES Primary outcomes were gestational length and birth weight . Electroencephalography ( EEG ) was done on the second day of life and at 3 months of age . Novelty preference ( Fagan test ) was used as an indicator of cognitive function at 6 and 9 months of age . The fatty acid pattern in umbilical plasma phospholipids and in breast milk was measured , and dietary assessment s were performed , both on the mothers during pregnancy and on the infants at 3 months of age . The growth of the infants was followed up to 1 year of age . RESULTS Three hundred forty-one mothers took part in the study until delivery . There were no significant differences in maternal body mass index before pregnancy and at birth , or parity between the 2 groups . Smoking habits and parental education were also similar in the 2 groups . The mean age of the mothers receiving cod liver oil was , by chance , 1 year higher than the age of the mothers receiving corn oil ( 28.6 [ 3.4 ] vs 27.6 [ 3.2 ] years ) . The maternal dietary intake in the 2 groups receiving cod liver oil or corn oil was similar , except for the supplementation . There were no differences in gestational length or birth weight between the cod liver oil group and the corn oil group ( 279.6 [ 9.2 ] vs 279.2 [ 9.3 ] days ; 3609 [ 493 ] vs 3618 [ 527 ] g , respectively ) . Birth length , head circumference , and placental weight were also similar in the 2 groups . The concentrations of the n-3 fatty acids eicosapentaenoic acid ( 20:5 n-3 ) , docosapentaenoic acid ( 22:5 n-3 ) , and DHA in umbilical plasma phospholipids were higher in the cod liver oil group compared with the corn oil group ( 10.8 [ 7.6 ] vs 2.5 [ 1.8 ] microg/mL , 5.0 [ 2.6 ] vs 2.9 [ 1.3 ] microg/mL , 55.8 [ 20.6 ] vs 45.3 [ 12.8 ] microg/mL , respectively ) . Neonates with high concentration of DHA in umbilical plasma phospholipids ( upper quartile ) had longer gestational length than neonates with low concentration ( lower quartile ; 282.5 [ 8.5 ] vs 275.4 [ 9.3 ] days ) . No differences in EEG scores or Fagan scores were found , but neonates with mature EEG ( N = 70 ) had a higher concentration of DHA in umbilical plasma phospholipids than neonates with immature EEG ( N = 51 ) on the second day of life . Dietary information from 251 infants at 3 months of age was collected and 85 % of these infants were exclusively breastfed , in addition to 12 % who were partly breastfed . The breast milk of mothers supplemented with cod liver oil contained more n-3 long-chain PUFAs and less n-6 long-chain PUFAs than breast milk of mothers supplemented with corn oil . There were no significant differences in infant growth during the first year of life between the 2 groups . CONCLUSIONS This study shows neither harmful nor beneficial effects of maternal supplementation of long-chain n-3 PUFAs regarding pregnancy outcome , cognitive development , or growth , as compared with supplementation with n-6 fatty acids . However , it confirms that DHA concentration may be related to gestational length and cerebral maturation of the newborn 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 r and omly assigned to supervised , double-blind supplementation once per week from approximately 18 weeks of pregnancy until delivery . Supplementation comprised 120 mg Fe+500 microg folic acid with ( n 94 ) or without ( n 94 ) 4800 microg 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 Maternal caregiving capacity , which is affected in part by cognition and mood , is crucial for the health of mothers and infants . Few interventions aim to improve maternal and infant health through improving such capacity . Multiple micronutrient ( MMN ) supplementation may improve maternal cognition and mood , since micronutrients are essential for brain function . We assessed mothers who participated in the Supplementation with Multiple Micronutrients Intervention Trial ( SUMMIT ) , a double-blind cluster-r and omized trial in Indonesia comparing MMN supplementation to iron and folic acid ( IFA ) during pregnancy and until three months postpartum . We adapted a set of well-studied tests of cognition , motor dexterity , and mood to the local context and administered them to a r and om sample of 640 SUMMIT participants after an average of 25 weeks ( SD = 9 ) of supplementation . Analysis was by intention to treat . Controlling for maternal age , education , and socio-economic status , MMN result ed in a benefit of 0.12 SD on overall cognition , compared to IFA ( 95%CI 0.03–0.22 , p = .010 ) , and a benefit of 0.18 SD on reading efficiency ( 95%CI 0.02–0.35 , p = .031 ) . Both effects were found particularly in anemic ( hemoglobin<110 g/L ; overall cognition : B = 0.20 , 0.00–0.41 , p = .055 ; reading : B = 0.40 , 0.02–0.77 , p = .039 ) and undernourished ( mid-upper arm circumference<23.5 cm ; overall cognition : B = 0.33 , 0.07–0.59 , p = .020 ; reading : B = 0.65 , 0.19–1.12 , p = .007 ) mothers . The benefit of MMN on overall cognition was equivalent to the benefit of one year of education for all mothers , to two years of education for anemic mothers , and to three years of education for undernourished mothers . No effects were found on maternal motor dexterity or mood . This is the first study demonstrating an improvement in maternal cognition with MMN supplementation . This improvement may increase the quality of care mothers provide for their infants , potentially partly mediating effects of maternal MMN supplementation on infant health and survival . The study is registered as an International St and ard R and omized Controlled Trial , number IS RCT N34151616 . http://www.controlled-trials.com/IS RCT Beverley-Anne Biggs and colleagues conduct a community-based cluster r and omized trial in rural Viet Nam to compare the effect of antenatal iron-folic acid supplementation taken daily or twice weekly on  maternal and infant outcomes . Please see later in the article for the Editors ' Background Concern that mild iodine deficiency in pregnancy may adversely affect neurodevelopment of offspring has led to recommendations for iodine supplementation in the absence of evidence from r and omised controlled trials . The primary objective of the study was to investigate the effect of iodine supplementation during pregnancy on childhood neurodevelopment . Secondary outcomes included pregnancy outcomes , maternal thyroid function and general health . Methods Women with a singleton pregnancy of fewer than 20 weeks were r and omly assigned to iodine ( 150 μg/d ) or placebo from trial entry to birth . Childhood neurodevelopment was assessed at 18 months by using Bayley Scales of Infant and Toddler Development ( Bayley-III ) . Iodine status and thyroid function were assessed at baseline and at 36 weeks ’ gestation . Pregnancy outcomes were collected from medical records . Results The trial was stopped after 59 women were r and omly assigned following withdrawal of support by the funding body . There were no differences in childhood neurodevelopmental scores between the iodine treated and placebo groups . The mean cognitive , language and motor scores on the Bayley-III ( iodine versus placebo , respectively ) were 99.4 ± 12.2 versus 101.7 ± 8.2 ( mean difference ( MD ) −2.3 , 95 % confidence interval ( CI ) −7.8 , 3.2 ; P = 0.42 ) , 97.2 ± 12.2 versus 97.9 ± 11.5 ( MD −0.7 , 95 % CI −7.0 , 5.6 ; P = 0.83 ) and 93.9 ± 10.8 versus 92.4 ± 9.7 ( MD 1.4 , 95 % CI −4.0 , 6.9 ; P = 0.61 ) , respectively . No differences were identified between groups in any secondary outcomes . Conclusions Iodine supplementation in pregnancy did not result in better childhood neurodevelopment in this small trial . Adequately powered r and omised controlled trials are needed to provide conclusive evidence regarding the effect of iodine supplementation in pregnancy . Trials registration The trial was registered with the Australian New Zeal and Clinical Trials Registry at http://www.anzctr.org.au . The registration number of this trial is ACTRN12610000411044 . The trial was registered on 21 May 2010 Objective : To assess the effects of antenatal omega 3 long-chain polyunsaturated fatty acid ( n-3 LC PUFA ) on cognitive development in a cohort of children whose mothers received high-dose fish oil in pregnancy . Design : A double-blind r and omised placebo-controlled trial . Setting : Perth , Western Australia , Australia . Patients : 98 pregnant women received the supplementation from 20 weeks ’ gestation until delivery . Their infants ( n = 72 ) were assessed at age 2½ years . Interventions : Fish oil ( 2.2 g docosahexaenoic acid ( DHA ) and 1.1 g eicosapentaenoic acid (EPA)/day ) or olive oil from 20 weeks ’ gestation until delivery . Outcome measures : Effects on infant growth and developmental quotients ( Griffiths Mental Development Scales ) , receptive language ( Peabody Picture Vocabulary Test ) and behaviour ( Child Behaviour Checklist ) . Results : Children in  the fish oil-supplemented group ( n = 33 ) attained a significantly higher score for eye and h and coordination ( mean ( ( SD ) score 114 ( 10.2 ) ) than those in the placebo group ( n = 39 , mean score 108 ( SD 11.3 ) ; p = 0.021 , adjusted p = 0.008 ) . Eye and h and coordination scores correlated with n-3 PUFA levels in cord blood erythrocytes ( EPA : r = 0.320 , p = 0.007 ; DHA : r = 0.308 , p = 0.009 ) and inversely correlated with n-6 PUFA ( arachidonic acid 20:4n-6 : r = −0.331 , p = 0.005 ) . Growth measurements in the two groups were similar at age 2½ years . Conclusion : Maternal fish oil supplementation during pregnancy is safe for the fetus and infant , and may have potentially beneficial effects on the child ’s eye and h and coordination . Further studies are needed to determine the significance of this finding A r and omised double-blind prevention trial with a factorial design was conducted at 33 centres in seven countries to determine whether supplementation with folic acid ( one of the vitamins in the B group ) or a mixture of seven other vitamins ( A , D , B1,B2,B6,C and nicotinamide ) around the time of conception can prevent neural tube defects ( anencephaly , spina bifida , encephalocele ) . A total of 1817 women at high risk of having a pregnancy with a neural tube defect , because of a previous affected pregnancy , were allocated at r and om to one of four groups -- namely , folic acid , other vitamins , both , or neither .  1195 had a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect ; 27 of these had a known neural tube defect , 6 in the folic acid groups and 21 in the two other groups , a 72 % protective effect ( relative risk 0.28 , 95 % confidence interval 0.12 - 0.71 ) . The other vitamins showed no significant protective effect ( relative risk 0.80 , 95 % Cl 0.32 - 1.72 ) . There was no demonstrable harm from the folic acid supplementation , though the ability of the study to detect rare or slight adverse effects was limited . Folic acid supplementation starting before pregnancy can now be firmly recommended for all women who have had an affected pregnancy , and public health measures should be taken to ensure that the diet of all women who may bear children contains an adequate amount of folic acid Supplementation of docosahexaenoic acid ( DHA ) in infancy improves neuro-developmental outcomes , but there is limited information about the impact of supplementing pregnant mothers with DHA on the development of their infants . In a follow-up of a r and omized , double-blind controlled trial with 400 pregnant mothers , the effects of supplementation of fish-oil or soy-oil ( 4 g/day ) during the last trimester of pregnancy on psychomotor development and behaviour of infants at 10 months of age ( n=249 ) were assessed . The quality of psychosocial stimulation at home ( HOME ) and nutritional status of the subjects were also measured . There were no significant differences in the fish-oil group and soy-oil group in any of the developmental ( mean + /-SD mental development index : 102.5 + /- 8.0 vs. 101.5 + /- 7.8 , psychomotor development index : 101.7 + /- 10.0 vs. 100.5 + /- 10.1 ) or behavioural outcomes . It may , therefore , be concluded that supplementation of fish-oil during the last trimester of pregnancy does not have any added benefit over supplementation of soy-oil on the development or behaviour of infants in this population CONTEXT Iron and zinc are important for the development of both intellectual and motor skills . Few studies have examined whether iron and zinc supplementation during gestation , a critical period of central nervous system development , affects children 's later functioning . OBJECTIVE To examine intellectual and motor functioning of children whose mothers received micronutrient supplementation during pregnancy . DESIGN , SETTING , AND PARTICIPANTS Cohort follow-up of 676 children aged 7 to 9 years in June 2007-April 2009 who had been born to women in 4 of 5 groups of a community-based , double-blind , r and omized controlled trial of prenatal micronutrient supplementation between 1999 and 2001 in rural Nepal . Study children were also in the placebo group of a subsequent preschool iron and zinc supplementation trial . INTERVENTIONS Women whose children were followed up had been r and omly assigned to receive daily iron/folic acid , iron/folic acid/zinc , or multiple micronutrients containing these plus 11 other micronutrients , all with vitamin A , vs a control group of vitamin A alone from early pregnancy through 3 months postpartum . These children did not receive additional micronutrient supplementation other than biannual vitamin A supplementation . MAIN OUTCOME MEASURES Children 's intellectual functioning , assessed using the Universal Nonverbal Intelligence Test ( UNIT ) ; tests of executive function , including go/no-go , the Stroop test , and backward digit span ; and motor function , assessed using the Movement Assessment Battery for Children ( MABC ) and finger-tapping test . RESULTS The difference across outcomes was significant ( Bonferroni-adjusted P < .001 ) for iron/folic acid vs control but not for other supplement groups . The mean UNIT T score in the iron/folic acid group was 51.7 ( SD , 8.5 ) and in the control group was 48.2 ( SD , 10.2 ) , with an adjusted mean difference of 2.38 ( 95 % confidence interval [ CI ] , 0.06 - 4.70 ; P = .04 ) . Differences were not significant between the control group and either the iron/folic acid/zinc ( 0.73 ; 95 % CI , -0.95 to 2.42 ) or multiple micronutrient ( 1.00 ; 95 % CI , -0.55 to 2.56 ) groups . In tests of executive function , scores were better in the iron/folic acid group relative to the control group for the Stroop test ( adjusted mean difference in proportion who failed , -0.14 ; 95 % CI , -0.23 to -0.04 ) and backward digit span ( adjusted mean difference , 0.36 ; 95 % CI , 0.01 - 0.71 ) but not for the go/no-go test . The MABC score was lower ( better ) in the iron/folic acid group compared with the control group but not after adjustment for confounders ( mean difference , -1.47 ; 95 % CI , -3.06 to 0.12 ; P = .07 ) . Finger-tapping test scores were higher ( mean difference , 2.05 ; 95 % CI , 0.87 - 3.24 ; P = .001 ) in the iron/folic acid group . CONCLUSION Aspects of intellectual functioning including working memory , inhibitory control , and fine motor functioning among offspring were positively associated with prenatal iron/folic acid supplementation in an area where iron deficiency is prevalent . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00115271 BACKGROUND Docosahexanoic acid ( DHA ) is an important constituent of the brain . Evidence from well- design ed intervention trials of the long-term benefits of increasing DHA intake during pregnancy has been sparse . OBJECTIVE We evaluated global cognition , behavior , and attention at age 5 y in the offspring of Mexican women who participated in a r and omized controlled trial of prenatal DHA supplementation . DESIGN A total of 1094 women were r and omly assigned to receive 400 mg of either DHA or placebo/d from 18 to 22 wk of pregnancy until delivery . We assessed cognitive development and behavioral and executive functioning , including attention , in 797 offspring at age 5 y ( 82 % of 973 live births ) with the use of the McCarthy Scales of Children 's Abilities ( MSCA ) , the parental scale of the Behavioral Assessment System for Children , Second Edition ( BASC-2 ) , and the Conners ' Kiddie Continuous Performance Test ( K-CPT ) . We compared the groups on raw scores , T-scores , and st and ardized scores , as appropriate . We examined heterogeneity by the quality of the home environment , maternal intelligence , and socioeconomic status . RESULTS There were no group differences for MSCA scores ( P > 0.05 ) , but the positive effect of the home environment at 12 mo on general cognitive abilities was attenuated in the DHA group compared with in the placebo group ( P-interaction < 0.05 ) . There were no differences between groups on the BASC-2 . On the K-CPT , offspring in the DHA group showed improved mean ± SD T-scores compared with those of the placebo group for omissions ( DHA : 47.6 ± 10.3 ; placebo : 49.6 ± 11.2 ; P < 0.01 ) with no differences ( P > 0.05 ) for the other K-CPT scores or of the proportion who were clinical ly at risk of attention deficit hyperactivity disorders after Bonferroni correction for multiple comparisons . CONCLUSION Prenatal exposure to DHA may contribute to improved sustained attention in preschool children . This trial was registered at clinical trials.gov as NCT00646360 BACKGROUND Docosahexaenoic acid ( DHA ) accumulates in the hippocampus and frontal lobes of the fetal brain during the last trimester of pregnancy . These areas of the brain contribute to attention and working memory and inhibitory control ( WMIC ) . OBJECTIVE We evaluated the effect of maternal omega-3 ( n-3 ) long-chain polyunsaturated fatty acid supplementation in pregnancy on child attention and WMIC . DESIGN A total of 185 term-born children of mothers who were r and omly allocated to consume 800 mg DHA/d ( treatment ) or a placebo ( control )  from ∼20 wk of gestation until birth were assessed with multiple measures of attention and WMIC at a mean ( ± SD ) of 27 ± 2 mo . Primary outcomes were the average time it took to be distracted when playing with a toy ( distractibility ) and the accuracy of remembering a new hiding location while inhibiting a learned response to search in the previous location ( WMIC ) . RESULTS Assessment s were completed by 81 children in the treatment group ( mean ± SD age : 835 ± 50.4 d ) and 77 children in the control group ( 839 ± 65.6 d ) . There was no effect of supplementation on primary outcomes [ distractibility mean difference : -0.2 s ( 95 % CI : -0.7 , 0.4 s ) ; WMIC mean difference : 8.9 mm ( 95 % CI : -10.6 , 28.3 mm ) ] . There was no difference between DHA-supplemented and control groups except that treatment-group children looked away from the toys fewer times than controls when presented with multiple toys competing for attention but less accurately remembered a repeated hiding location . These secondary effects were not consistent with any other outcomes and may have been a result of chance . Cord plasma DHA was not consistently associated with attention and WMIC . CONCLUSION Maternal DHA supplementation during pregnancy does not enhance attention or WMIC in term-born preschoolers . The DHA for Maternal and Infant Outcomes trial was registered at www.anzctr.org.au as ACTRN1260500056906 We investigated the response inhibition function of the prefrontal cortex associated with the go/no-go task using functional magnetic resonance imaging in five human subjects . The go/no-go task consisted of go and no-go trials given r and omly with roughly equal probability . In go trials a green square was presented and the subjects had to respond by promptly pushing a button using their right or left thumbs , but in no-go trials a red square was presented and subjects were instructed not to respond . When brain activity in no-go trials is dominant over that in go trials in areas in the prefrontal cortex , this no-go dominant brain activity would reflect the neural processes for inhibiting inherent response tendency . We used a new strategy of image data analysis by which transient brain activity in go or no-go trials can be analysed separately , and looked for the prefrontal areas in which the brain activity in no-go trials is dominant over that in go trials . We found the no-go dominant foci in the posterior part of the right inferior frontal sulcus reproducibly among the subjects . This was true whether the right or left h and was used . These results suggest that this region in the prefrontal cortex is related to the neural mechanisms underlying the response inhibition function The benefits of iodine supplements during pregnancy remain controversial in areas with a mild-to-moderate iodine deficiency . The aim of the present study was to determine the effect of improving iodine intakes , with iodised salt ( IS ) or iodine supplements , in pregnant Spanish women . A total of 131 pregnant women in their first trimester were r and omly assigned to three groups : ( 1 ) IS in cooking and at the table , ( 2 ) 200 μg potassium iodide (KI)/d or ( 3 ) 300 μg KI/d . No differences were found in thyroid-stimulating hormone ( TSH ) , free thyroxine ( FT4 ) , free triiodothyronine ( FT3 ) or thyroid volume ( TV ) between the three groups . Regardless of the group in which women were included , those who had been taking IS for at least 1 year before becoming pregnant had a significantly lower TV in the third trimester ( P= 0.01 ) and a significantly higher urinary iodine in the first ( 173.7 ( sd 81.8 ) v. 113.8 ( sd 79.6 ) μg/l , P= 0.001 ) and third trimesters ( 206.3 ( sd 91.2 ) v. 160.4 ( sd 87.7 ) μg/l , P= 0.03 ) . Also , no differences were seen in TSH , FT4 or FT3 . Children 's neurological development was not significantly associated with the consumption of IS for at least 1 year before becoming pregnant and no differences were found according to the treatment group . In conclusion , in pregnant women with insufficient iodine intake , the intake of IS before becoming pregnant was associated with a better maternal thyroid function . The form of iodide intake was not associated with maternal thyroid function or children 's neurological development BACKGROUND Zinc deficiency is widely prevalent in developing countries . Zinc supplements given to Bangladeshi pregnant women have been shown to reduce infants ' infectious disease morbidity . We assessed these infants at age 13 months to establish the effect of antenatal zinc supplementation on infant development and behaviour . METHODS The study originally consisted of 559 pregnant women who were r and omly allocated to zinc ( 30 mg daily ) or placebo ( cellulose ) from 4 months ' gestation to delivery . The effect of zinc supplementation on pregnancy outcome and on infant growth and morbidity in the first 6 months was assessed . We then r and omly selected a sub sample of 168 infants from 383 who completed the study at 6 months . When babies in this sub sample reached age 13 months , we assessed mental development with Bayley scales of infant development-II , rated behaviour on a modified version of Wolke 's scales , and measured weight and height . FINDINGS When we controlled for differences between tested and non-tested participants , infants in the placebo group had higher scores on mental development index ( regression coefficient=3.3 , SE 1.6 , 95 % CI 0.2 - 6.5 , p=0.04 ) and psychomotor development index ( 5.1 , 2.4 , 0.2 - 9.9 , p=0.04 ) than those in the zinc-supplemented group . Zinc supplementation had no significant effect on behaviour or growth . The children 's nutritional status was poor , and weight-for-age at testing was strongly related to developmental levels , which accounted for some of the treatment effect . INTERPRETATION Prenatal supplementation with zinc alone in poor women from Bangladesh does not seem to confer benefit on infants ' mental development . Such treatment should be considered with caution Abstract Maternal nutritional status during pregnancy impacts fetal brain development .  Vitamin B12 plays a vital role in neuronal development . However , findings from studies on the association between maternal B12 status and child cognitive functions have been inconsistent . We performed a r and omized , placebo‐controlled clinical trial of oral B12 supplementation ( 50 & mgr;g ) beginning at < 14 weeks of gestation through a 6‐week post‐partum . In the present study , we report the effects of maternal B12 supplementation on cognitive development in infants at 9 months of age on Bayley Scales of Infant Development‐III ( BSID‐III ) . One hundred eighty‐three pregnant women received vitamin B12 , and 183 received placebo . Nine‐month BSID‐III development score was available in 178 infants . There were no significant differences in maternal sociodemographic characteristics and baseline biochemical measures between infants who underwent BSID‐III evaluation and infants who were not evaluated . There were no significant differences in any of the subscales of BSID‐III between infants born to mothers who received B12 supplementation  ( n = 78 ) vs. placebo ( n = 100 ) . On multiple regression analysis , elevated maternal total homocysteine ( tHcy ) levels adjusted for treatment group , birthweight , parity , income and home environment at second trimester of pregnancy were significantly negatively associated with expressive language ( & bgr ; = 3.13 points , P < 0.001 ) , and in third trimester of pregnancy with expressive language ( & bgr ; = −2.29 points , P < 0.001 ) and fine motor ( & bgr ; = −1.41 points , P = 0.005 ) domains of BSID‐III . While no significant effects of maternal B12 supplementation were seen on cognitive development in infants at 9 months of age , elevated maternal tHcy levels were associated with poorer cognitive performance in some of the subdomains of BSID‐III . In pregnant women with elevated tHcy levels and or B12 deficiencies , it may be worthwhile to study the impact of longer term maternal supplementation on infant cognitive outcomes OBJECTIVE . We investigated the benefits of maternal multimicronutrient supplementation during gestation on the mental and psychomotor development  of infants . METHODS . In a double-blind , r and omized , controlled trial , pregnant women ( N = 5828 ) in 2 rural counties in western China were assigned r and omly 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 BACKGROUND During fetal and perinatal periods , many nutrients , such as long-chain polyunsaturated fatty acids [ contained in fish oil ( FO ) ] and folate , are important in achieving normal brain development . Several studies have shown the benefits of early nutrition on children 's neurocognitive development . However , the evidence with regard to the attention system is scarce . OBJECTIVES The aim of this study was to analyze the long-term effects of FO , 5-methyltetrahydrofolate ( 5-MTHF ) , or FO+5-MTHF prenatal supplementation on attention networks . DESIGN Participants were 136 children born to mothers from the NUHEAL ( Nutraceuticals for a Healthy Life ) project ( r and omly assigned to receive FO and /or 5-MTHF or placebo prenatal supplementation )  who were recalled for a new examination 8.5 y later . The response conflict-resolution ability ( using congruent and incongruent conditions ) ) , alerting , and spatial orienting of attention were evaluated with behavioral measures ( Attention Network Test ) , electroencephalography/event-related potentials ( ERPs ) , and st and ardized low-resolution brain electromagnetic tomography ( sLORETA ) . RESULTS Children born to mothers supplemented with 5-MTHF alone solved the response conflict more quickly than did the placebo and the FO+5-MTHF groups ( all P < 0.05 ) . Differences between ERP amplitudes for the conflict conditions were also observed . sLORETA analysis showed higher activation of the right midcingulate cortex for the incongruent condition . In addition , a significant slowing down of response speed depending on the warning cue in the 5-MTHF and FO groups was observed . CONCLUSIONS Folate supplementation during pregnancy , rather than FO or FO+5-MTHF supplementation , improves children 's ability to solve response conflicts . This advantage seems to be based on the higher activation of the midcingulate cortex , indicating that early nutrition influences the functionality of specific brain areas involved in executive functions . This trial was registered at clinical trials.gov as NCT01180933 The effect of maternal nutritional supplementation during pregnancy and lactation on the mental and motor development of infants was studied in a rural population in Taiwan . Women were r and omly assigned to 2 treatment groups : 1 received a high-calorie and protein supplement ( " supplement " group ) ; the other received a placebo ( " control " group ) . Infants received no direct supplementation . At approximately 8 months of age , the mental and motor development of the infants was assessed using a research to maternal supplementation in either scale , nor were the mental scale scores of infants of supplement mothers significantly higher than infants of control mothers . However , the motor scores of supplement infants were higher than those of control infants , which is consistent with the findings of 2 other large-scale nutritional supplementation studies The  Delayed Response task is the best-established marker of frontal lobe function in nonhuman primates . This article reports the developmental progression of human infants on that task . It is proposed that maturation of prefrontal cortex may make possible these age-related improvements in Delayed Response performance . This would suggest the importance of prefrontal cortex functioning very early in life . Twelve infants ( 6 male , 6 female ) were tested longitudinally every two weeks from 6 - 12 months of age . Another 36 infants ( 18 male , 18 female ) were tested only once : 12 each at 8 , 10 , and 12 months . We predicted that infants would improve on Delayed Response over these ages because infants ' performance on AB improves during this time , and Delayed Response is very similar to AB . The AB task , devised by Piaget , is used to study cognitive development in infants . The ages over which AB performance improves are well established . In both AB and Delayed Response , the subject watches as the experimenter hides a desired object in one of two identical wells . After a brief delay , the subject is allowed to reach . In AB , the object is hidden in the same well on subsequent trials until the subject reaches to the correct well ; then side of hiding is reversed and the procedure repeated . In Delayed Response , side of hiding is varied r and omly over trials . In the present study of Delayed Response each testing session consisted of 16 trials ( eight to the right , eight to the left ) . We found : ( 1 ) the developmental progression for Delayed Response is almost identical to that for AB . ( 2 ) Infants of 7 1/2 - 9 months fail Delayed Response under the same conditions and in the same ways as do monkeys with lesions of dorsolateral prefrontal cortex . It is therefore suggested that AB and Delayed Response require the same cognitive abilities , and that improved performance on these tasks provides an index of maturation of frontal cortex function Colombian women at risk of mild-to-moderate malnutrition were enrolled in a health care program and r and omly assigned into nutritional supplementation and control groups at the beginning of the third trimester of preganancy . One hundred unsupplemented and 144 supplemented infants were tested at 15 days of age : a 2X2 checkerboard was presented eight times followed by a single presentation of a 6X6 checkerboard . Unsupplemented infants showed less initial attention followed by slower habituation and higher levels of movement than the supplemented infants . The observed effect of maternal nutritional supplementation during the last trimester of pregnancy on new-born attention was interpreted to be maturational in nature Infants born to families at risk of malnutrition were studied prospect ively from the beginning of the 3rd trimester of the mother 's pregnancy until the child reached 3 yr of age to ascertain the effects of nutritional supplementation and /or a maternal education program on their cognitive development . Four hundred thirty-three families were assigned r and omly to six groups : group A served as a control ; group B received the supplement from the age of 6 months to 3 yr ; group C received the supplement during the 3rd trimester of pregnancy and the first 6 months of the child 's life ; and group D received the supplement throughout the entire study period . In addition , group A1 was enrolled in a maternal education program but received no nutritional supplement and group B1 received both treatments . The Griffiths test of infant development was administered at 4 , 6 , 12 , 18 , 24 , and 36 months of age , and the Corman-Escalona Einstein scale was administered at each age up to 18 months . Children who received food supplementation performed better than those who did not , especially on subtests that were primarily motoric . The effect of food supplementation on behavior appeared to be contemporaneous . In addition , the treatment effects were more pronounced for girls than for boys in this sample . Although these interventions reduced the gap in cognitive performance between lower and upper socioeconomic classes , a disparity nevertheless remained by the end of the study BACKGROUND Choline is essential for fetal brain development , and it is not known whether a typical American diet contains enough choline to ensure optimal brain development . OBJECTIVE The study was undertaken to determine whether supplementing pregnant women with phosphatidylcholine ( the main dietary source of choline ) improves the cognitive abilities of their offspring . DESIGN In a double-blind , r and omized controlled trial , 140 pregnant women were r and omly assigned to receive supplemental phosphatidylcholine ( 750 mg ) or a placebo ( corn oil ) from 18 wk gestation through 90 d postpartum . Their infants ( n = 99 ) were tested for short-term visuospatial memory , long-term episodic memory , language development , and global development at 10 and 12 mo of age . RESULTS The women studied ate diets that delivered ∼360 mg choline/d in foods ( ∼80 % of the recommended intake for pregnant women , 65 % of the recommended intake for lactating women ) . The phosphatidylcholine supplements were well tolerated . Groups did not differ significantly in global development , language development , short-term visuospatial memory , or long-term episodic memory . CONCLUSIONS Phosphatidylcholine supplementation of pregnant women eating diets containing moderate amounts of choline did not enhance their infants ' brain function . It is possible that a longer follow-up period would reveal late-emerging effects . Moreover , future studies should determine whether supplementing mothers eating diets much lower in choline content , such as those consumed in several low-income countries , would enhance infant brain development Infants were followed longitudinally to document the relationship between docosahexaenoic acid ( DHA ) levels and the development of attention . Erythrocyte ( red-blood cell ; RBC ) phospholipid DHA ( percentage of total fatty acids ) was measured from infants and mothers at delivery . Infants were assessed in infant-control habituation at 4 , 6 , and 8 months augmented with psychophysiological measures , and on free-play attention and distractibility paradigms at 12 and 18 months . Infants whose mothers had high DHA at birth showed an accelerated decline in looking over the 1st year and increases in examining during single-object exploration and less distractibility in the 2nd year . These findings are consistent with evidence suggesting a link between DHA and cognitive development in infancy OBJECTIVES . Arachidonic acid ( 20:4n-6 ) and docosahexaenoic acid ( 22:6n-3 ) are essential for brain growth and cognitive development . We have reported that supplementing pregnant and lactating women with n-3 very-long-chain polyunsaturated fatty acids promotes higher IQ scores at 4 years of age as compared with maternal supplementation with n-6 polyunsaturated fatty acids . In our present study , the children were examined at 7 years of age with the same cognitive tests as at 4 years of age . We also examined the relation between plasma fatty acid pattern and BMI in children , because an association between arachidonic acid and adipose tissue size has been suggested . METHODS . The study was r and omized and double-blinded . The mothers took 10 mL of cod liver oil or corn oil from week 18 of pregnancy until 3 months after delivery . Their children were tested with the Kaufman Assessment Battery for Children at 7 years of age , and their height and weight were measured . RESULTS . We did not find any significant differences in scores on the Kaufman Assessment Battery for Children test at 7 years of age between children whose mothers had taken cod liver oil ( n = 82 ) or corn oil ( n = 61 ) . We observed , however , that maternal plasma phospholipid concentrations of α-linolenic acid ( 18:3n-3 ) and docosahexaenoic acid during pregnancy were correlated to sequential processing at 7 years of age . We observed no correlation between fatty acid status at birth or during the first 3 months of life and BMI at 7 years of age . CONCLUSION . This study suggests that maternal concentration of n-3 very-long-chain polyunsaturated fatty acids during pregnancy might be of importance for later cognitive function , such as sequential processing , although we observed no significant effect of n-3 fatty acid intervention on global IQs . Neonatal fatty acid status had no influence on BMI at 7 years of age
BACKGROUND Epidemiological studies have demonstrated that folate , iodine and iron intake during pregnancy impacts on foetal brain development and cognitive function .
However , in human studies , the relationship with other dietary nutrients is less clear .
OBJECTIVE This systematic review aims to critically appraise the current literature and meta-analyses results from nutritional interventions during pregnancy that aim ed to optimise infant and child cognitive outcomes .