Prenatal nutrition, stimulation, and exposure to punishment are associated with early child motor, cognitive, language, and socioemotional development in Dar es Salaam, Tanzania.
Helen O Pitchik, Wafaie W Fawzi, Dana Charles McCoy and 6 others
PMID 30124230WHAT IT FOUND
High caregiver stimulation was associated with higher reported cognitive/language scores, verbal and physical punishment with lower reported socioemotional scores, and prenatal vitamin A with lower reported motor scores in 198 Tanzanian children.
Key findings
01Prenatal vitamin A supplementation, given with or without zinc and alongside standard iron and folic acid, was associated with lower caregiver-reported motor development scores.
02High caregiver stimulation was associated with higher cognitive/language scores, and verbal and physical punishment was associated with lower socioemotional scores.
03Maternal primary school education was associated with higher motor and cognitive/language scores, while preterm birth, birthweight, small-for-gestational-age birth, and growth measures were not associated with development scores.
STILL TO COME
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What it does not show
Only 198 children were analysed, and 20% had incomplete data for the motor score, so small associations may have been missed. The follow-up sample was selected from a larger trial, and only about 35% of attempted contacts were assessed, so it may not represent all children from the trial. Development scores came from caregiver reports, which can be affected by memory and by what caregivers want to report. The study did not measure maternal depression, social or emotional neglect, delivery complications, or observed parent-child interaction. The sample was urban Tanzanian mothers who started antenatal care in the first trimester, so it may not apply to rural settings or to mothers who start care late. The parent trial was designed to study placental malaria and birth outcomes, not child development.
Declared interests
The authors reported no conflicts of interest. The supplied publication type indicates NIH extramural support, but the article text does not state who paid for this follow-up study.
The easy way to misread this
Do not conclude that prenatal vitamin A harms motor development. The lower motor score was an association in a small selected follow-up sample, and the child development study was not the parent trial's main purpose.