Zhu Z, et al. - The long-term association of antenatal micronutrient supplementation with adolescent intellectual development was evaluated in this analysis. Researchers reported that antenatal multiple micronutrient supplementation seemed to be linked to increased adolescent intellectual development compared with folic acid plus iron or folic acid capsules supplementation. It was noted that starting supplementation in the first trimester of pregnancy and afterwards proceeding for at least 180 days were associated with the greatest rewards.

Methods

•  This 14-year follow-up study of a randomized clinical trial of micronutrient supplementation in pregnancy was performed in 2 counties in rural western China.
• Participants in the study were 2118 adolescent offspring (aged 10 to 14 years) of mothers who were randomized to take a daily capsule of either folic acid, folic acid plus iron, or multiple micronutrients from August 1, 2002, through February 28, 2006.
• Researchers conducted follow-up from June 1, 2016, through December 31, 2016.
• From April 1, 2017, to June 20, 2017, data analyses took place.
• By the Wechsler Intelligence Scale for Children, adolescent full-scale intelligence quotient and aspects of verbal comprehension, working memory, perceptual reasoning, and processing speed indexes were evaluated.

Results

• Out of 2118 adolescent offspring, 1252 (59.1%) were boys and 866 (40.9%) were girls, with a mean (SD) age of 11.7 (0.87) years, representing 47.2% of the 4488 single live births that were eligible to take an interest.
• Multiple micronutrient supplementation was correlated with a 1.13-point higher full-scale intelligence quotient (95% CI, 0.15-2.10) and a 2.03-point higher verbal comprehension index (95% CI, 0.61-3.45) compared with folic acid supplementation.
• Researchers found similar results in comparison with folic acid plus iron.
• Multiple micronutrient capsules were correlated with a 2.16-point higher full-scale intelligence quotient (95% CI, 0.41-3.90) and 4.29-point higher verbal comprehension index (95% CI, 1.33-7.24) compared with folic acid capsules when mothers initiated supplementation early (<12 weeks of gestation) and had an adequate dose (≥180 capsules).
• It was observed that the mean test scores were lower in the substratum of supplementation initiated late (≥12 weeks of gestation) and with an inadequate dose (<180 capsules).
• When compared with the folic acid plus iron group, the multiple micronutrient group had higher scores than the other 2 treatment groups, and significant differences were noted for full-scale intelligence quotient (adjusted mean difference, 2.46; 95% CI, 0.98-3.94).