Objectives
To assess if preconception supplementation with multiple micronutrients (MM) or iron and folic acid (IFA) improved offspring development at 2 y compared to folic acid only (FA).
Methods
We followed up 1639 offspring born to women who participated in a randomized controlled trial of preconception micronutrient supplementation in rural Vietnam (PRECONCEPT). A total of 5011 women (18-40 y) received weekly supplements containing either 2800 µg FA, 60 mg iron and 2800 µg FA, or the same amount of IFA and other micronutrients, from baseline until conception; all women received daily prenatal supplements containing 60 mg iron and 400 µg FA during pregnancy until delivery. We measured child development using the Bayley Scales for Infant Development (BSID-III) at 2 years of age (n=1400). The quality of home environment was assessed using the HOME inventory. Intent to treat analyses were conducted using analysis of variance
Results
We found significant differences by treatment group for fine motor development at age 2 y (MM:107.3±12.5, IFA:109.5±13.2, FA:107.91±13.2; p=0.03), but no differences for measures of cognition, receptive or expressive language. There were no differences by treatment group for baseline maternal characteristics, birth outcomes or quality of home environment
Conclusions
Preconception supplementation with IFA improved fine motor development at age 2 y when compared to FA, but no differences were seen for MM. The lack of benefits for the MM group remain to be explained; further follow-up will help ascertain if the observed differences translate to improved cognition later on.
