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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 #337018

Title: Associations of maternal nutrition during pregnancy and postpartum with maternal cognition and caregiving

item PRADO, EL - University Of California
item ASHORN, U - University Of Tampere Medical School
item PHUKA, J - University Of Malawi
item MALETA, K - University Of Malawi
item SADALAKI, J - University Of Malawi
item OAKS, B - University Of California
item HASKELL, M - University Of California
item Allen, Lindsay - A
item VOSTI, SA - University Of California
item ASHORN, P - University Of Tampere Medical School
item DEWEY, KG - University Of California

Submitted to: Journal of Federation of American Societies for Experimental Biology
Publication Type: Abstract Only
Publication Acceptance Date: 1/30/2017
Publication Date: 4/1/2017
Citation: Prado, E., Ashorn, U., Phuka, J., Maleta, K., Sadalaki, J., Oaks, B., Haskell, M., Allen, L.H., Vosti, S., Ashorn, P., Dewey, K. 2017. Associations of maternal nutrition during pregnancy and postpartum with maternal cognition and caregiving. Journal of Federation of American Societies for Experimental Biology. 31(1):298.4. Available:

Interpretive Summary:

Technical Abstract: Brain function depends on a continuous supply of nutrients, including micronutrients and fatty acids. Pregnancy and postpartum (pp) are periods of increased nutrient demands, during which optimal maternal cognition is important to prepare for a healthy birth and care for a young infant. However, few studies of nutrition and cognition have been conducted in pregnant women. Our first objective was to assess the differences in maternal cognition and mother-child interaction (MCI) between groups of women in Malawi who received different nutritional supplements from = 20 weeks gestation to 6 mo pp. The second objective was to test 14 pre-specified effect modifiers. The third objective was to examine associations between maternal cognition at 6 mo pp and the following biomarkers of iron, Vitamin A, and fatty acid status: zinc protoporphyrin, soluble transferrin receptor, plasma retinol, arachidonic acid, and docosahexaenoic acid (DHA) concentrations. This study was conducted as a part of the International Lipid-Based Nutrient Supplements (iLiNS) DYAD-M Project, a randomized trial with three groups. From enrollment to delivery, one group received daily iron (60 mg) and folic acid (IFA), a second group received daily multiple (18) micronutrients (MMN) (including 20 mg iron/d), and the third group received 20 g/d lipid-based nutrient supplements (LNS), including 20 mg/d iron plus additional nutrients. From delivery to 6 mo pp, the MMN and LNS groups continued to receive the same supplements and the IFA group received placebo. At 6 mo pp, maternal cognition was assessed with digit span forward and backward, verbal fluency, mental rotation, and functional health literacy (FHL) tests. MCI was assessed with an adapted version of the HOME Inventory. Out of 869 women enrolled, 712 (82%) participated in cognitive testing and 669 (77%) participated in assessment of MCI. In the only significant effect in the full group, women who received IFA scored higher than the LNS group in mental rotation (B = 0.20, 95% CI 0.01–0.39, p = 0.03), particularly among women with low mid-upper arm circumference (MUAC) at enrollment (Figure 1). In women with low MUAC, ZPP at 6 mo pp was associated with mental rotation scores (B = -0.81, -1.54–-0.08, p = 0.03), therefore, this effect may be related to the higher dose of iron in the IFA group. In mothers with low Hb/iron status or malaria at enrollment, LNS was associated with higher executive function compared to IFA, particularly verbal fluency (Figure 1). Adjusting for covariates, verbal fluency was associated with baseline plasma DHA (B = 0.76, 0.17-1.35, p = 0.01), change in plasma DHA from baseline to 36 wk gestation (B = 0.17, 0.01-0.33, p = 0.04), and breastmilk DHA at 6 mo pp (B = 0.25, 0.01-0.49, p = 0.04), therefore this effect may be related to supplementation with its precursor, alpha-linolenic acid, in LNS. While maternal nutrition was associated with higher scores on specific cognitive tests in certain sub-groups, no associations were found with measures more directly related to child care: FHL and MCI. Funded by the Bill & Melinda Gates Foundation