Effects of pre- and post-natal lipid-based nutrient supplements on infant development in a randomized trial in Ghana.

BACKGROUND: Maternal and infant undernutrition is negatively associated with infant development. AIMS: We tested the hypothesis that provision of small-quantity lipid-based nutrient supplements (SQ-LNS) to pregnant women and infants positively affects infant development. STUDY DESIGN: In a partially double-blind randomized controlled trial, we compared the following daily maternal supplements during pregnancy and until 6months post-partum: iron/folic acid capsule (IFA), capsule containing 18 micronutrients (MMN), or 20g SQ-LNS. Children in the SQ-LNS group also received SQ-LNS from age 6 to 18months. The study is registered as NCT00970866. SUBJECTS: 1320 pregnant women in Ghana enrolled in the trial; 1173 of their children participated in developmental assessment. OUTCOME MEASURES: We monitored the acquisition of 10 developmental milestones monthly by parental report, observed the attainment of 6 motor milestones at 6, 12, and 18months, and conducted detailed assessment of motor, language, socio-emotional, and executive function at 18months. RESULTS: By researcher observation, a greater percentage of children in the SQ-LNS group (53%) was able to walk alone at 12months than in the IFA group (43%; RR=1.23, 95% CI=1.02-1.49; p=0.025). We found no significant differences between groups in milestone acquisition by parent report or in any scores at 18months. The difference in mean z-scores between groups ranged from 0.03-0.13 for motor (p=0.84), 0.01-0.08 for language (p=0.46), 0.01-0.02 for socio-emotional (p=0.75), and 0.00-0.02 for executive function (p=0.95). CONCLUSION: While provision of maternal and child SQ-LNS in Ghana may affect walking at 12months, it did not affect infant development at 18months.