Effect of maternal antenatal and newborn supplementation with vitamin A on cognitive development of school-aged children in rural Bangladesh: a follow-up of a placebo-controlled, randomized trial
Effect of maternal antenatal and newborn supplementation with vitamin A on cognitive development of school-aged children in rural Bangladesh: a follow-up of a placebo-controlled, randomized trial
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DOI：
10.3945/ajcn.116.134478
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发表时间：
2017-07-01
影响因子：
7.1
通讯作者：
Christian, Parul
中科院分区：
文献类型：
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作者：
Ali, Hasmot;Hamadani, Jena;Christian, Parul
背景：早期补充维生素 A 对神经发育功能的影响尚未得到充分研究。在孟加拉国农村地区，我们检查了一组在子宫内或出生时接触维生素 A 的儿童的认知和运动功能以及学业成绩。目的：本研究的目的是检查产前和新生儿补充维生素 A 对 8 岁儿童认知功能的独立和综合影响。设计：来自 2 个先前双盲、 2013 年 2 月至 2014 年 6 月期间，对 8 岁时的安慰剂对照整群随机试验进行了重新审视。关于社会人口、社会和身体状况的数据；上学；儿童保育行为；人体测量测量；结果：在父母试验中最后已知还活着的 11,950 名儿童中，在选定的连续研究区域按治疗组平衡的 1803 名儿童中的一个子集被重新纳入，其中 1613 名 (89%) 同意进行评估。其中，1577 名（87%）儿童接受了完整的认知评估。所有组在之前试验中收集的基线变量和重新入组时测量的因素都具有高度可比性。总体而言，孕产妇或新生儿补充维生素 A 对智力、记忆和运动功能没有影响。与安慰剂相比，接受两种干预措施的儿童在阅读、拼写和数学计算方面的表现明显更好，平均 (95% CI) 分数分别增加为 8.0 (2.2, 13.8)、6.8 (1.9, 11.7) 和 4.8 (0.6, 9.0)。结论：产前或新生儿补充维生素 A 不会影响一般智力或记忆和运动功能。 当提供两种干预措施时，执行功能的各个方面都会得到改善。
Background: The impact of early vitamin A supplementation on neurodevelopmental function has not been adequately studied. In rural Bangladesh we examined cognitive and motor function and scholastic achievement in a cohort of children who were exposed to vitamin A in utero or at birth.Objective: The aim of this study was to examine independent and combined effects of antenatal and newborn supplementation with vitamin A on the cognitive function of children at 8 y of age.Design: A cohort of rural Bangladeshi children from 2 previous double-blind, placebo-controlled cluster-randomized trials were revisited at age 8 y between February 2013 and June 2014. Data on sociodemographic, social, and physical conditions; schooling; child care behavior; anthropometric measures; and cognitive function were collected with the use of various psychometric assessment tools.Results: Among 11,950 children from the parent trial who were last known to be alive, a subset of 1803 children balanced by treatment group in a selected contiguous study area were re-enrolled and 1613 (89%) provided consent for assessments. Of these, 1577 (87%) children had a complete cognitive evaluation. All groups were highly comparable on baseline variables collected in the previous trials and factors measured at re-enrollment. Overall, there was no impact of either maternal or newborn supplementation with vitamin A on intelligence, memory, and motor function. Compared with placebo, children who received both interventions had significantly better performance in reading, spelling, and math computation, with increased mean (95% CI) scores of 8.0 (2.2, 13.8), 6.8 (1.9, 11.7), and 4.8 (0.6, 9.0), respectively.Conclusions: General intelligence or memory and motor functions were not affected by antenatal or newborn supplementation with vitamin A. Scholastic performance and aspects of executive function improved when both interventions were provided.