Does prenatal micronutrient supplementation improve children's mental development? A systematic review

Abstract

BackgroundAlthough maternal nutrient status influences all aspects of fetal development including the brain, the impact of micronutrient supplementation on the baby's mental function is a topic of debate. This systematic review assesses the effect of single and multiple micronutrient supplementation during pregnancy on offspring mental development.MethodsEleven electronic literature databases were searched using key terms of various combinations and filter string terms. Reference lists of articles selected for review were scanned for citations fitting the same inclusion criteria. Each stage of the literature retrieval and review process was conducted independently by two reviewers. The CONSORT checklist was used to assess study quality.ResultsA total of 1316 articles were retrieved from the electronic database search, of which 18 met the inclusion criteria and were evaluated. The selected studies were randomized controlled trials published from 1983 to 2010, with high variance in sample size, intervention type, and outcome measures. The median CONSORT score was 15 (range 12 - 19). Due to inconsistent interventions and outcome measures among the studies, no conclusive evidence was found that enhancing the intrauterine environment through micronutrient supplementation was associated with child mental development in a number of dimensions. There was some evidence to support n-3 fatty acids or multi-micronutrients having some positive effect on mental development, but the evidence for single nutrients was much weaker.ConclusionsThe study of children's mental outcomes as a function of prenatal supplementation is still relatively new, but the results of this systematic review suggest that further work with multiple micronutrients and/or n-3 fatty acids should be conducted.

The effect of maternal omega-3 (n-3) LCPUFA supplementation during pregnancy on early childhood cognitive and visual development: a systematic review and meta-analysis of randomized controlled trials

“…Unlike past reviews (20)(21)(22)(23)(24), we undertook an exhaustive search strategy and contacted authors to obtain unpublished data. Using well-established processes for conducting systematic reviews (25,58,59), we determined that many of the trials of LCPUFA supplementation in pregnancy had methodologic weaknesses; thus, it was not possible to draw any strong inferences from these trials.…”

“…RCTs of omega-3 LCPUFAs are increasingly being reported with varying results, and systematic reviews have attempted to evaluate the overall body of literature. However, these systematic reviews have not included several relevant trials and have not adequately reported the risk of bias for included studies (20)(21)(22)(23)(24). A comprehensive systematic review of RCTs conducted according to the Cochrane handbook (25) and for which results are quantified in a meta-analysis is needed.…”

The Role of Nutrition in Children's Neurocognitive Development, From Pregnancy Through Childhood

“…This review found some evidence that multivitamin and mineral supplementation might positively influence certain aspects of brain development in children (Leung et al, 2011). The review included six trials on multiple-micronutrient supplementations conducted in Peru, rural Taiwan, Tanzania (on HIV infected mothers), and in rural China, Indonesia and Bangladesh, where mothers were poorly nourished (Joos et al, 1983;Schmidt et al, 2004;McGrath et al, 2006;Tofail et al, 2008;Li et al, 2009;Caulfield et al, 2010).…”

Prenatal Micronutrient Supplementation Is Not Associated with Intellectual Development of Young School-Aged Children

“…However, the effects of micronutrient supplementation and the presence of a long-term impact on the childrenÕs mental development are still being debated and investigated (1).…”