The objective of this study was to examine the association of prenatal multivitamin/mineral supplement use during the first and second trimesters of pregnancy by low income, urban women in the Camden Study (1985-1995, n = 1,430) and preterm delivery (< 37 completed weeks) and infant low birth weight (< 2,500 g). Prenatal supplement use was corroborated by assay of circulating micronutrients at entry to care (no differences) and week 28 gestation (increased concentrations of folate and ferritin for supplement users). Compared with women who entered care during the first or second trimester but did not use prenatal supplements, supplement use starting in the first or second trimester was associated with approximately a twofold reduction in risk of preterm delivery. After controlling for potential confounding variables, risk of very preterm delivery (< 33 weeks' gestation) was reduced more than fourfold for first trimester users and approximately twofold when use dated from the second trimester. Infant low birth weight and very low birth weight (< 1,500 g) risks were also reduced. Risk of low birth weight was reduced approximately twofold with supplement use during the first and second trimester. Diminution in risk was greater for very low birth weight infants, amounting to a sevenfold reduction in risk of very low birth weight with first trimester supplementation and a greater than sixfold reduction when supplement use started in the second trimester. Thus, in low income, urban women, use of prenatal multivitamin/mineral supplements may have the potential to diminish infant morbidity and mortality.
Making good decisions requires thinking ahead, but the huge number of actions and outcomes one could consider makes exhaustive planning infeasible for computationally constrained agents, such as humans. How people are nevertheless able to solve novel problems when their actions have long-reaching consequences is thus a long-standing question in cognitive science. To address this question, we propose a model of resource-constrained planning that allows us to derive optimal planning strategies. We find that previously proposed heuristics such as best-first search are near-optimal under some circumstances, but not others. In a mouse-tracking paradigm, we show that people adapt their planning strategies accordingly, planning in a manner that is broadly consistent with the optimal model but not with any single heuristic model. We also find systematic deviations from the optimal model that might result from additional cognitive constraints that are yet to be uncovered.
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