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Preschool Iron‐Folic Acid and Zinc Supplementation in Children Exposed to Iron‐Folic Acid In Utero Confers No Added Cognitive Benefit in Early School‐age
Author(s) -
Christian Parul,
Morgan Mary E.,
MurrayKolb Laura,
LeClerq Steven C,
Khatry Subarna K.,
Schaefer Barbara,
Cole Pamela,
Katz Joanne,
Tielsch James M
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.236.5
Subject(s) - folic acid , zinc , in utero , medicine , folic acid supplementation , pediatrics , physiology , chemistry , pregnancy , biology , fetus , organic chemistry , genetics
Antenatal iron‐folic acid supplementation improves aspects of intellectual, executive, and fine motor function among school‐age offspring in rural Nepal. Using data from two RCTs, we examined whether combinations of added zinc to the maternal supplement (M‐IFAZn) and preschool supplementation from 12–36 mo with iron‐folic acid (C‐IFA) +/− zinc (C‐IFAZn) enhance cognitive outcomes beyond that seen with antenatal maternal iron‐folic acid (M‐IFA) alone. Relative to the M‐IFA group, child supplementation did not impact scores on the UNIT (Universal Nonverbal Intelligence Test), Stroop and go/no go tests. However, children in the C‐IFAZn group had lower scores on the backward digit span (adj −0.31, 95% CI: −0.59, −0.03) and movement assessment battery (adj 1.44, 95% CI: 0.20, 2.68). The combinations of C‐IFA (−2.36, 95% CI: −4.14, −0.58), C‐IFAZn (−1.92, 95% CI: −3.22, −0.63), and M‐IFAZn/C‐IFAZn (−2.04, 95% CI: −3.69, −0.44) produced lower finger tapping test scores after adjustment. Preschool iron‐folic acid +/− zinc to children exposed to iron‐folic acid in utero confers no additional benefit to cognitive outcomes assessed in early school age and may even diminish the positive effects of maternal iron‐folic acid; mechanisms underlying this warrant investigation. Support: NICHD, Gates Foundation.