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ARS Home » Pacific West Area » Davis, California » Western Human Nutrition Research Center » Obesity and Metabolism Research » Research » Publications at this Location » Publication #342273
Title: Associations of maternal nutrition during pregnancy and postpartum with maternal cognition and mother-child interaction

Author
item PRADO, ELIZABETH - University Of California
item ASHORN, ULLA - University Of Tampere
item PHUKA - University Of Malawi
item MALETA - University Of Malawi
item SADALAKI - University Of Malawi
item OAKS, BRIETTA - University Of California
item HASKELL, MARJORIE - University Of California
item Allen, Lindsay - A
item VOSTI, STEPHEN - University Of California Agriculture And Natural Resources (UCANR)
item ASHORN - University Of Tampere
item DEWEY, KATHRYN - University Of California

Submitted to: Maternal and Child Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/19/2017
Publication Date: 4/1/2018
Citation: Prado, E., Ashorn, U., Phuka, .J., Maleta, .K., Sadalaki, .J., Oaks, B.M., Haskell, M., Allen, L.H., Vosti, S.A., Ashorn, .P., Dewey, K.G. 2018. Associations of maternal nutrition during pregnancy and postpartum with maternal cognition and mother-child interaction. Maternal and Child Nutrition. 14:e12546. https://doi.org/10.1111/mcn.12546.
DOI: https://doi.org/10.1111/mcn.12546

Interpretive Summary: Pregnant and postpartum women need a higher intake of nutrients and optimal cognitive function, which depends on adequate nutrition, to provide good caregiving. We aimed to assess a) differences in maternal cognition and mother-child interaction (M-CI) between women in Malawi who received different nutritional supplements, b) factors that modified any effects of the nutrient supplements, and c) associations between cognition/M-CI and biomarkers of iron, vitamin A, B-vitamin, and fatty acid status. In a randomized controlled trial, 869 pregnant women daily received either iron/folic acid (IFA), multiple micronutrients (MMN), or 20 g/d lipid-based nutrient supplements (LNS). After delivery, supplementation continued in the MMN and LNS arms, and the IFA arm received placebo until 6 months postpartum, when cognition (n=712), M-CI (n=669), and biomarkers of nutritional status (n=283) were assessed. In the full group, only one difference was significant: the IFA arm scored higher than the LNS arm in mental rotation, especially among women with a small arm circumference at baseline. Among sub-groups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored higher in verbal fluency than the IFA group. Higher breastmilk docosahexaenoic acid (DHA) and vitamin B12 concentrations were associated with better verbal fluency and digit span forward scores. In this type of population, maternal supplementation with MMN or LNS does not improve maternal cognition or M-CI. Maternal DHA and B12 status may be important for postpartum attention and executive function.

Technical Abstract: Pregnant and postpartum women need increased nutrient intake and optimal cognition, which depends on adequate nutrition, to enable reasoning and learning for caregiving. We aimed to assess a) differences in maternal cognition and mother-child interaction (M-CI) between women in Malawi who received different nutritional supplements, b) effect modifiers, and c) associations between cognition/M-CI and biomarkers of iron, vitamin A, B-vitamin, and fatty acid status. In a randomized controlled trial (n=869), pregnant women daily received either iron/folic acid (IFA), multiple micronutrients (MMN), or 20 g/d lipid-based nutrient supplements (LNS). After delivery, supplementation continued in the MMN and LNS arms, and the IFA arm received placebo until 6 months postpartum, when cognition (n=712), M-CI (n=669), and biomarkers of nutritional status (n=283) were assessed. In the full group, only one difference was significant: the IFA arm scored 0.22 SD (95% CI 0.01, 0.39, p=0.03) higher than the LNS arm in mental rotation, with a greater difference among women with baseline small arm circumference (+0.71 SD; 95% CI 0.21, 1.22). Among sub-groups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored 0.4 to 0.7 SD higher than IFA in verbal fluency. Breastmilk docosahexaenoic acid (DHA) and vitamin B12 concentrations were associated with verbal fluency and digit span forward (adjusted ps<0.05). In this type of population, maternal supplementation with MMN or LNS does not seem to positively affect maternal cognition or M-CI. Maternal DHA and B12 status may be important for postpartum attention and executive function.