Elizabeth L. Prado|Susy Katikana Sebayang|Mandri Apriatni|Siti Robiah Adawiyah|Nina Hidayati|Ayuniarti Islamiyah|Sudirman Sudirman|Benyamin Harefa|Jarrad A. G. Lum|Katie Alcock|Michael T. Ullman|Husni Muadz|Anuraj H Shankar
Maternal multiple micronutrient supplementation and other biomedical and socioenvironmental influences on children's cognition at age 9–12 years in Indonesia: follow-up of the SUMMIT randomised trial
University of California, Davis|Deakin University|Lancaster University|Georgetown University|University of Mataram|Harvard University
h3backgroundh3 brain cognitive development first 1000 days conception affected multiple biomedical socioenvironmental determinants including nutrition health nurturing stimulation improved understanding longterm influence factors needed prioritise public health investments optimise human development h3methodsh3 followup study supplementation multiple micronutrients intervention trial summit doubleblind clusterrandomised trial maternal supplementation multiple micronutrients mmn iron folic acid ifa indonesia 27 356 live infants birth 3 months age 200104 reenrolled 19 274 70 children age 912 years randomly selected 2879 18 230 attending school known location 574 children oversampled mothers anaemic malnourished summit enrolment assessed effects mmn associations biomedical ie maternal child anthropometry haemoglobin preterm birth socioenvironmental determinants ie parental education socioeconomic status home environment maternal depression general intellectual ability declarative memory procedural memory executive function academic achievement fine motor dexterity socioemotional health summit trial registered number isrctn34151616 h3findingsh3 children mothers given mmn mean score 011 sd 95 ci 001020 p00319 higher procedural memory given ifa equivalent increase scores half year schooling children anaemic mothers mmn group scored 018 sd 006031 p00047 higher general intellectual ability similar increase 1 year schooling overall 18 21 tests showed positive coefficient mmn versus ifa p00431 effect sizes 000018 sd multiple regression models socioenvironmental determinants coefficients 000043 sd 22 35 tests significant 95 ci level whereas biomedical coefficients 000010 sd eight 56 tests significant indicating larger consistent impact socioenvironmental factors p00001 h3interpretationh3 maternal mmn longterm benefits child cognitive development 912 years age thereby supporting role early childhood development policy change toward mmn stronger association socioenvironmental determinants improved cognition suggests present reproductive maternal neonatal child health programmes focused biomedical determinants might sufficiently enhance child cognition programmes addressing socioenvironmental determinants essential achieve thriving populations h3fundingh3 grand challenges canada saving brains program