The Effect of Intermittent Antenatal Iron Supplementation on Maternal and Infant Outcomes in Rural Viet Nam: A Cluster Randomised Trial

Hanieh, Sarah; Ha, Tran Thu; Simpson, Julie A; Casey, Gerard J.; Khuong, Nguyen; Thoang, Dang Dinh; Thuy, Tran T; Pasricha, Sant‐Rayn; Tran, Thach; Tran, Thanh; Dwyer, Terence; Fisher, Jane; Biggs, Beverley‐Ann

doi:10.1371/journal.pmed.1001470

Cited by 51 publications

(89 citation statements)

References 26 publications

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“…In contrast, a trial of antenatal MMNs compared to either daily or twice-weekly IFA in Vietnamese women found that at the age of 6 months, children born to mothers in the twice-weekly IFA group had a higher Bayley cognitive score (mean difference 1.89) than children born to the daily IFA group ( p = 0.03), despite maternal ferritin levels being lower in this group [26] . No significant differences were found compared to the MMN group.…”

Section: Biological Effects Child Engagement Cognition Nutritionmentioning

confidence: 83%

Iron and Cognitive Development: What Is the Evidence?

2017

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The theoretical irreversible damage that iron deficiency and iron deficiency anemia can exert on child development makes a compelling argument for action to alleviate the burden. However, a critical analysis of evidence from iron interventions in early life is necessary to determine whether and how iron interventions improve cognitive outcomes. Key iron interventions used in clinical and public health practice include oral iron supplementation and, in young children, iron-containing multiple micronutrient powders. This article examines the evidence to answer 4 main questions. (1) Does antenatal iron supplementation influence long-term child cognitive development? (2) Does oral iron supplementation in preschool children improve short-term cognitive development? (3) Does oral iron supplementation in older children improve cognitive development? And (4), can provision of iron harm cognitive development? Early trials indicated benefit from parenteral iron in young children regardless of anemia status. There also appears to be evidence for benefit using oral iron treatment on cognitive performance in anemic primary school children. However, antenatal and early childhood oral iron intervention studies show inconsistent effects on early and long-term childhood cognitive outcomes. These data suggest either that (a) effects from oral iron on cognitive development in young children are small or nonexistent or that (b) heterogeneity between trials and the low quality of many studies make assessment of effect difficult. Importantly, few large, placebo-controlled trials in under-2-year-old children in low-income settings assessing effects of iron interventions on cognition have been performed; high-quality, placebo-controlled, adequately powered trials of universal iron interventions on cognitive performance in young children are urgently needed to justify policies of universal iron intervention in this group.

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Section: Biological Effects Child Engagement Cognition Nutritionmentioning

confidence: 83%

Iron and Cognitive Development: What Is the Evidence?

2017

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“…We calculated pooled effect sizes if at least five studies reported an intervention versus control group comparison in any category of intervention (eg, nutritional supplementation and promotion of responsive care and learning opportunities). We applied the same criterion to stratified 29 Ong et al 37 Jeon et al 41 Lind et al 31 Rosado et al 15 Oelofse et al 52 Nahar et al 48 Smuts et al 62 Husaini et al 50 Phuka et al 21 Maleta et al 17 Krebs et al 54 Bauserman et al 55 Faber et al 14 Hess et al 16 Dewey et al 20 77 Luby et al 23 Stewart et al 22 Gladstone et al 61 Lees et al 80 Hallamaa et al 82 Tomlinson et al 78 Tumwine et al 79 Dewey et al 20 Adu-Afarwuah et al 18 Ashorn et al 19 Zhang et al 59 Thomas et al 60 Gowachirapant et al 51 Hamadani et al 35 Jacobson et al 58 Schmidt et al 53 Hanieh 36 Zhu et al 56 Nguyen et al 34 Christian et al 40 Gonzalez-Casano 87 Tofail et al 49 In utero 3 6 9 12 15 18 Months Years 64 Nahar et al 48 Hamadani et al 70 Tofail et al…”

Section: Data Collection and Analysismentioning

confidence: 99%

Do effects of early life interventions on linear growth correspond to effects on neurobehavioural development? A systematic review and meta-analysis

Prado

Larson

Cox

et al. 2019

The Lancet Global Health

138

146

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Background Faltering in linear growth and neurobehavioural development during early childhood are often assumed to have common causes because of their consistent association. This notion has contributed to a global focus on the promotion of nutrition during pregnancy and childhood to improve both conditions. Our aim was to assess whether effects of interventions on linear growth are associated with effects on developmental scores and to quantify these associations.Methods In this systematic review and meta-analysis, we included randomised trials done during pregnancy and in children aged 0-5 years that reported effects of any intervention on length-for-age or height-for-age Z scores (LAZ or HAZ) and on any of the following outcomes: motor, cognitive or mental, language, and social-emotional or behavioural development. We searched MEDLINE (Ovid), CINAHL (EBSCO), and PsycINFO (EBSCO) from database inception to June 25, 2019. Study-level data were extracted and, when required, authors were contacted for missing information. We calculated weighted meta-regression coefficients of the association between standardised effect sizes of interventions on LAZ or HAZ and developmental outcome scores and calculated pooled effect sizes for different types of intervention.Findings Of the 7207 studies identified, we included 75 studies with 122 comparisons between intervention and control groups and outcomes reported for 72 275 children. Across all interventions, effect sizes on LAZ or HAZ were significantly associated with effect sizes on social-emotional scores (β 0·23, 95% CI 0·05 to 0·41; p=0·02), but not on cognitive (0·18, -0·36 to 0·72; p=0·51), language (0·12, -0·07 to 0·31; p=0·21), or motor development scores (0·23, -0·05 to 0·50; p=0·11). In studies that provided nutritional supplements, we observed positive significant pooled effect sizes on all five outcomes of LAZ or HAZ (effect size 0·05, 95% CI 0·01-0·09; p=0·01; n=50), cognitive or mental (0·06, 0·03-0·10; p<0·01; n=38), language (0·08, 0·03-0·13; p=0·01; n=21), motor (0·08, 0·04-0·12; p<0·01; n=41), and social-emotional (0·07, 0·02-0·12; p=0·01; n=20) scores. The effect sizes of nutritional supplementation on LAZ or HAZ scores were significantly associated with effect sizes on cognitive (β 0·40, 95% CI 0·04-0·77; p=0·049) and motor (0·43, 0·11-0·75; p=0·01) scores. In the 14 interventions promoting responsive care and learning opportunities, the pooled effect size on LAZ or HAZ score was not significant (-0·01, 95% CI -0·07 to 0·05; p=0·74), but pooled effect sizes on cognitive, language, and motor scores were 4 to 5 times larger (range 0·38-0·48) than the pooled effect sizes of nutritional supplementation (0·05-0·08). Interpretation In nutritional supplementation interventions, improvements in linear growth were associated with small improvements in child development, whereas nurturing and stimulation interventions had significant effects on child development but no effectson linear growth. The determinants of linear growth and neurodevelopment are only partly ...

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“…; Hanieh et al . ). The IBM‐V Care subscale and Control subscale mean scores changed slightly, but not significantly between baseline and follow‐up.…”

Section: Resultsmentioning

confidence: 97%

Common mental disorders among women, social circumstances and toddler growth in rural Vietnam: a population‐based prospective study

Fisher

Tran

Nguyen

et al. 2015

Child

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The Effect of Intermittent Antenatal Iron Supplementation on Maternal and Infant Outcomes in Rural Viet Nam: A Cluster Randomised Trial

Abstract: Beverley-Anne Biggs and colleagues conduct a community-based cluster randomized 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' Summary

Cited by 51 publications

References 26 publications

Iron and Cognitive Development: What Is the Evidence?

Iron and Cognitive Development: What Is the Evidence?

Do effects of early life interventions on linear growth correspond to effects on neurobehavioural development? A systematic review and meta-analysis

Common mental disorders among women, social circumstances and toddler growth in rural Vietnam: a population‐based prospective study

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