human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES . To determine the association between maternal multivitamin supplementation and the mental and psychomotor development of children who are born to HIV-1–infected mothers in Tanzania , as secondary endpoints in a r and omized trial that investigated the effect of maternal multivitamin supplementation on HIV-1 vertical transmission and progression . METHODS . The Bayley Scales of Infant Development , 2nd Edition , were administered at 6 , 12 , and 18 months of age to a subset of children ( N = 327 ) . We assessed the effect of vitamin A and multivitamin ( vitamins B , C , and E ) supplementation using linear regression models and Cox proportional hazard models for the Mental Development Index , the Psychomotor Development Index , and raw scores separately . RESULTS . Multivitamin supplementation was associated significantly with a mean increase in Psychomotor Development Index score of 2.6 ( 95 % confidence interval : 0.1–5.1 ) . Multivitamins were also significantly protective against the risk for developmental delay on the motor scale ( relative risk : 0.4 ; 95 % confidence interval : 0.2–0.7 ) but not on the Mental Development Index .  Vitamin A supplementation had no significant effect on these outcomes . CONCLUSIONS . Maternal multivitamin supplements provide a low-cost intervention to reduce the risk for developmental delays among infants who are born to HIV-positive mothers in developing countries OBJECTIVES Docosahexaenoic acid ( DHA ; 22:6 n-3 ) and arachidonic acid ( AA ; 20:4 n-6 ) are important for development of the central nervous system in mammals . There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months , with a large increase in the cerebral content of AA and DHA .  The fetus and the newborn infant depend on maternal supply of DHA and AA . Our hypothesis was that maternal intake of DHA during pregnancy and lactation is marginal and that high intake of this fatty acid would benefit the child . We examined the effect of supplementing pregnant and lactating women with very-long-chain n-3 polyunsaturated fatty acids ( PUFAs ; cod liver oil ) on mental development of the children , compared with maternal supplementation with long-chain n-6 PUFAs ( corn oil ) . METHODS The study was r and omized and double-blinded . Pregnant women were recruited in week 18 of pregnancy to take 10 mL of cod liver oil or corn oil until 3 months after delivery . The cod liver oil contained 1183 mg/10 mL DHA , 803 mg/10 mL eicosapentaenoic acid ( 20:5 n-3 ) , and a total of 2494 mg/10 mL summation operator n-3 PUFAs . The corn oil contained 4747 mg/10 mL linoleic acid ( 18:2 n-6 ) and 92 mg/10 mL alpha-linolenic acid ( 18:3 n-3 ) . The amount of fat-soluble vitamins was identical in the 2 oils ( 117 micro g/mL vitamin A , 1 micro g/mL vitamin D , and 1.4 mg/mL dl-alpha-tocopherol ) . A total of 590 pregnant women were recruited to the study , and 341 mothers took part in the study until giving birth . All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age , and 262 complied with the request . As part of the protocol , 135 subjects from this population were invited for intelligence testing  with the Kaufman Assessment Battery for Children ( K-ABC ) at 4 years of age . Of the 135 invited children , 90 came for assessment . Six children did not complete the examination . The K-ABC is a measure of intelligence and achievement design ed for children aged 2.5 years through 12.5 years . This multisubtest battery comprises 4 scales : Sequential Processing , Simultaneous Processing , Achievement ( not used in the present study ) , and Nonverbal Abilities . The Sequential Processing and Simultaneous Processing scales are hypothesized to reflect the child 's style of problem solving and information processing . Scores from these 2 scales are combined to form a Mental Processing Composite , which serves as the measure of intelligence in the K-ABC . RESULTS We received dietary information from 76 infants ( 41 in the cod liver oil group and 35 in the corn oil group ) , documenting that all of them were breastfed at 3 months of age . Children who were born to mothers who had taken cod liver oil ( n = 48 ) during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken  corn oil  ( n = 36 ; 106.4 [ 7.4 ] vs 102.3 [ 11.3 ] ) . The Mental Processing Composite score correlated significantly with head circumference at birth ( r = 0.23 ) , but no relation was found with birth weight or gestational length . The children 's mental processing scores at 4 years of age correlated significantly with maternal intake of DHA and eicosapentaenoic acid during pregnancy . In a multiple regression model , maternal intake of DHA during pregnancy was the only variable of statistical significance for the children 's mental processing scores at 4 years of age . CONCLUSION Maternal intake of very-long-chain n-3 PUFAs during pregnancy and lactation may be favorable for later mental development of children Within the visual system , docosahexaenoic acid ( DHA , 22:6n−3 ) is an important structural component for retinal photoreceptors and cortical gray matter . There is a marked decrease in neural DHA accumulation in the face of DHA deficiency . DHA is accumulated at an accelerated rate during pregnancy , especially in the third trimester . However , pregnant women in the US and Canada have dietary DHA intakes that are significantly below the optimal level . The main objective of this study was to determine whether a DHA-functional food during pregnancy would benefit infant visual acuity at four and six months of age measured behaviorally using the acuity card procedure ( ACP ) . In a r and omized , longitudinal , double-blinded , and placebo-controlled trial , 30 pregnant women received either the DHA-functional food ( n = 16 ) or the placebo ( n = 14 ) . There were significant main effects for visual acuity at four months of age ( P = 0.018 ) . The mean acuity scores were 3.8 ± 1.1 cycles/degree in the DHA group versus 3.2 ± 0.7 cycles/degree in the placebo group . At six months there were no group differences . Based on our results , we conclude that DHA supplemented during pregnancy plays a role in the maturation of the visual system BACKGROUND Iron supplements are often prescribed during pregnancy despite the lack of intervention trials that have assessed the effects of supplementation in pregnancy on childhood development . OBJECTIVE The objective was to determine whether iron supplementation during pregnancy influences  childhood intelligence quotient ( IQ )  in an industrialized country . DESIGN Pregnant women ( n = 430 ) were r and omly allocated to receive iron ( 20 mg/d ) or placebo from 20 wk gestation until delivery , and the women and their children were followed up over the long term ( 4 y ) . Seventy percent of these families participated in the follow-up . The proportion of women with iron deficiency anemia at the end of pregnancy was 1 % ( 2 of 146 ) in the iron group and 11 % ( 15 of 141 ) in the placebo group . The primary outcome was the IQ of the children at 4 y of age , as assessed by the Stanford-Binet Intelligence Scale . Secondary outcomes included child behavior and the general health of the mothers . RESULTS The mean IQ was not significantly different ( P = 0.980 ) between the children of the iron-supplemented mothers ( 109 + /- 11 ; n = 153 ) and the children of the mothers in the placebo group ( 109 + /- 11 ; n = 149 ) . However , the percentage of children with an abnormal behavior score was higher in the iron group ( 24 of 151 , or 16 % ) than in the placebo group ( 12 of 149 , or 8 % ) ; the relative risk was 1.97 ( 95 % CI : 1.03 , 3.80 ; P = 0.037 ) . There was no significant difference in the health of the mothers between groups , as assessed by the SF-36 Health Survey . CONCLUSIONS Prenatal iron supplementation that reduces the incidence of iron deficiency anemia from 11 % to 1 % has no effect on the IQ of the offspring at 4 y of age BACKGROUND A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals , but this association in humans is controversial . OBJECTIVE We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that result ed in increased head circumference and birth weight .  DESIGN The children took 6 tests-the Differential Ability Scales , Visual Sequential Memory , Auditory Sequential Memory , Knox Cube , Gross Motor Scale , and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo . RESULTS There were no differences in the test scores of neurologic development between the 2 groups . We analyzed the scores in 4 subgroups on the basis of maternal body mass index , because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index ( in kg/m(2 ) ) < 26.0 in the original trial . No differences in the scores were found between these subgroups . CONCLUSIONS Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other population BACKGROUND Docosahexaenoic acid ( DHA ) is important to neural development . Whether DHA intakes are low enough in some pregnant women to impair infant development is uncertain . OBJECTIVE We sought to determine whether DHA deficiency occurs in pregnant women and contributes to poor infant development . DESIGN Biochemical cutoffs , dietary intakes , or developmental scores indicative of DHA deficiency are not defined . Infant development has a distribution in which an individual 's potential development is unknown . This was a r and omized intervention to establish a distribution of developmental scores for infants of women with DHA intakes considered to be above requirements against which to compare the development of infants of mothers consuming their usual diet .  DHA ( 400 mg/d ; n = 67 ) or a placebo ( n = 68 ) was consumed by the women from 16 wk gestation until delivery . We determined maternal red blood cell ethanolamine phosphoglyceride fatty acids , dietary intakes at 16 and 36 wk gestation , and infant visual acuity at 60 d of age . RESULTS We described an approach to identify DHA deficiency when biochemical and functional markers of deficiency are unknown . In multivariate analyses , infant visual acuity was related to sex ( beta = 0.660 , SE = 0.93 , and odds ratio = 1.93 ) and maternal DHA intervention ( beta = 1.215 , SE = 1.64 , and odds ratio = 3.37 ) . More infant girls in the placebo than in the DHA intervention group had a visual acuity below average ( P = 0.048 ) . Maternal red blood cell ethanolamine phosphoglyceride docosatetraenoic acid was inversely related to visual acuity in boys ( rho = -0.37 , P < 0.05 ) and girls ( rho = -0.48 , P < 0.01 ) . CONCLUSIONS These studies suggest that some pregnant women in our study population were DHA-deficient BACKGROUND There are few studies reporting on docosahexaenoic acid ( DHA , 22:6n-3 ) supplementation during pregnancy and infant cognitive function . DHA supplementation in pregnancy and infant problem solving in the first year have not been investigated . OBJECTIVE We tested the hypothesis that infants born to women who consumed a DHA-containing functional food during pregnancy would demonstrate better problem-solving abilities and recognition memory than would infants born to women who consumed the placebo during pregnancy . DESIGN In a double-blind , placebo-controlled , r and omized trial , pregnant women consumed a DHA-containing functional food or a placebo from gestation week 24 until delivery . Study groups received DHA-containing cereal-based bars ( 300 mg DHA/92-kcal bar ; average consumption : 5 bars/wk ; n = 14 ) or cereal-based placebo bars ( n = 15 ) . The Infant Planning Test and Fagan Test of Infant Intelligence were administered to infants at age 9 mo . The problem-solving trial included a support step and a search step . The procedure was scored on the basis of the infant 's performance on each step and on the entire problem ( intention score 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES . To determine the association between maternal multivitamin supplementation and the mental and psychomotor development of children who are born to HIV-1–infected mothers in Tanzania , as secondary endpoints in a r and omized trial that investigated the effect of maternal multivitamin supplementation on HIV-1 vertical transmission and progression . METHODS . The Bayley Scales of Infant Development , 2nd Edition , were administered at 6 , 12 , and 18 months of age to a subset of children ( N = 327 ) . We assessed the effect of vitamin A and multivitamin ( vitamins B , C , and E ) supplementation using linear regression models and Cox proportional hazard models for the Mental Development Index , the Psychomotor Development Index , and raw scores separately . RESULTS . Multivitamin supplementation was associated significantly with a mean increase in Psychomotor Development Index score of 2.6 ( 95 % confidence interval : 0.1–5.1 ) . Multivitamins were also significantly protective against the risk for developmental delay on the motor scale ( relative risk : 0.4 ; 95 % confidence interval : 0.2–0.7 ) but not on the Mental Development Index .  Vitamin A supplementation had no significant effect on these outcomes . CONCLUSIONS . Maternal multivitamin supplements provide a low-cost intervention to reduce the risk for developmental delays among infants who are born to HIV-positive mothers in developing countries OBJECTIVES Docosahexaenoic acid ( DHA ; 22:6 n-3 ) and arachidonic acid ( AA ; 20:4 n-6 ) are important for development of the central nervous system in mammals . There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months , with a large increase in the cerebral content of AA and DHA .  The fetus and the newborn infant depend on maternal supply of DHA and AA . Our hypothesis was that maternal intake of DHA during pregnancy and lactation is marginal and that high intake of this fatty acid would benefit the child . We examined the effect of supplementing pregnant and lactating women with very-long-chain n-3 polyunsaturated fatty acids ( PUFAs ; cod liver oil ) on mental development of the children , compared with maternal supplementation with long-chain n-6 PUFAs ( corn oil ) . METHODS The study was r and omized and double-blinded . Pregnant women were recruited in week 18 of pregnancy to take 10 mL of cod liver oil or corn oil until 3 months after delivery . The cod liver oil contained 1183 mg/10 mL DHA , 803 mg/10 mL eicosapentaenoic acid ( 20:5 n-3 ) , and a total of 2494 mg/10 mL summation operator n-3 PUFAs . The corn oil contained 4747 mg/10 mL linoleic acid ( 18:2 n-6 ) and 92 mg/10 mL alpha-linolenic acid ( 18:3 n-3 ) . The amount of fat-soluble vitamins was identical in the 2 oils ( 117 micro g/mL vitamin A , 1 micro g/mL vitamin D , and 1.4 mg/mL dl-alpha-tocopherol ) . A total of 590 pregnant women were recruited to the study , and 341 mothers took part in the study until giving birth . All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age , and 262 complied with the request . As part of the protocol , 135 subjects from this population were invited for intelligence testing  with the Kaufman Assessment Battery for Children ( K-ABC ) at 4 years of age . Of the 135 invited children , 90 came for assessment . Six children did not complete the examination . The K-ABC is a measure of intelligence and achievement design ed for children aged 2.5 years through 12.5 years . This multisubtest battery comprises 4 scales : Sequential Processing , Simultaneous Processing , Achievement ( not used in the present study ) , and Nonverbal Abilities . The Sequential Processing and Simultaneous Processing scales are hypothesized to reflect the child 's style of problem solving and information processing . Scores from these 2 scales are combined to form a Mental Processing Composite , which serves as the measure of intelligence in the K-ABC . RESULTS We received dietary information from 76 infants ( 41 in the cod liver oil group and 35 in the corn oil group ) , documenting that all of them were breastfed at 3 months of age . Children who were born to mothers who had taken cod liver oil ( n = 48 ) during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken  corn oil  ( n = 36 ; 106.4 [ 7.4 ] vs 102.3 [ 11.3 ] ) . The Mental Processing Composite score correlated significantly with head circumference at birth ( r = 0.23 ) , but no relation was found with birth weight or gestational length . The children 's mental processing scores at 4 years of age correlated significantly with maternal intake of DHA and eicosapentaenoic acid during pregnancy . In a multiple regression model , maternal intake of DHA during pregnancy was the only variable of statistical significance for the children 's mental processing scores at 4 years of age . CONCLUSION Maternal intake of very-long-chain n-3 PUFAs during pregnancy and lactation may be favorable for later mental development of children Within the visual system , docosahexaenoic acid ( DHA , 22:6n−3 ) is an important structural component for retinal photoreceptors and cortical gray matter . There is a marked decrease in neural DHA accumulation in the face of DHA deficiency . DHA is accumulated at an accelerated rate during pregnancy , especially in the third trimester . However , pregnant women in the US and Canada have dietary DHA intakes that are significantly below the optimal level . The main objective of this study was to determine whether a DHA-functional food during pregnancy would benefit infant visual acuity at four and six months of age measured behaviorally using the acuity card procedure ( ACP ) . In a r and omized , longitudinal , double-blinded , and placebo-controlled trial , 30 pregnant women received either the DHA-functional food ( n = 16 ) or the placebo ( n = 14 ) . There were significant main effects for visual acuity at four months of age ( P = 0.018 ) . The mean acuity scores were 3.8 ± 1.1 cycles/degree in the DHA group versus 3.2 ± 0.7 cycles/degree in the placebo group . At six months there were no group differences . Based on our results , we conclude that DHA supplemented during pregnancy plays a role in the maturation of the visual system BACKGROUND Iron supplements are often prescribed during pregnancy despite the lack of intervention trials that have assessed the effects of supplementation in pregnancy on childhood development . OBJECTIVE The objective was to determine whether iron supplementation during pregnancy influences  childhood intelligence quotient ( IQ )  in an industrialized country . DESIGN Pregnant women ( n = 430 ) were r and omly allocated to receive iron ( 20 mg/d ) or placebo from 20 wk gestation until delivery , and the women and their children were followed up over the long term ( 4 y ) . Seventy percent of these families participated in the follow-up . The proportion of women with iron deficiency anemia at the end of pregnancy was 1 % ( 2 of 146 ) in the iron group and 11 % ( 15 of 141 ) in the placebo group . The primary outcome was the IQ of the children at 4 y of age , as assessed by the Stanford-Binet Intelligence Scale . Secondary outcomes included child behavior and the general health of the mothers . RESULTS The mean IQ was not significantly different ( P = 0.980 ) between the children of the iron-supplemented mothers ( 109 + /- 11 ; n = 153 ) and the children of the mothers in the placebo group ( 109 + /- 11 ; n = 149 ) . However , the percentage of children with an abnormal behavior score was higher in the iron group ( 24 of 151 , or 16 % ) than in the placebo group ( 12 of 149 , or 8 % ) ; the relative risk was 1.97 ( 95 % CI : 1.03 , 3.80 ; P = 0.037 ) . There was no significant difference in the health of the mothers between groups , as assessed by the SF-36 Health Survey . CONCLUSIONS Prenatal iron supplementation that reduces the incidence of iron deficiency anemia from 11 % to 1 % has no effect on the IQ of the offspring at 4 y of age BACKGROUND A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals , but this association in humans is controversial . OBJECTIVE We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that result ed in increased head circumference and birth weight .  DESIGN The children took 6 tests-the Differential Ability Scales , Visual Sequential Memory , Auditory Sequential Memory , Knox Cube , Gross Motor Scale , and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo . RESULTS There were no differences in the test scores of neurologic development between the 2 groups . We analyzed the scores in 4 subgroups on the basis of maternal body mass index , because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index ( in kg/m(2 ) ) < 26.0 in the original trial . No differences in the scores were found between these subgroups . CONCLUSIONS Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other population BACKGROUND Docosahexaenoic acid ( DHA ) is important to neural development . Whether DHA intakes are low enough in some pregnant women to impair infant development is uncertain . OBJECTIVE We sought to determine whether DHA deficiency occurs in pregnant women and contributes to poor infant development . DESIGN Biochemical cutoffs , dietary intakes , or developmental scores indicative of DHA deficiency are not defined . Infant development has a distribution in which an individual 's potential development is unknown . This was a r and omized intervention to establish a distribution of developmental scores for infants of women with DHA intakes considered to be above requirements against which to compare the development of infants of mothers consuming their usual diet .  DHA ( 400 mg/d ; n = 67 ) or a placebo ( n = 68 ) was consumed by the women from 16 wk gestation until delivery . We determined maternal red blood cell ethanolamine phosphoglyceride fatty acids , dietary intakes at 16 and 36 wk gestation , and infant visual acuity at 60 d of age . RESULTS We described an approach to identify DHA deficiency when biochemical and functional markers of deficiency are unknown . In multivariate analyses , infant visual acuity was related to sex ( beta = 0.660 , SE = 0.93 , and odds ratio = 1.93 ) and maternal DHA intervention ( beta = 1.215 , SE = 1.64 , and odds ratio = 3.37 ) . More infant girls in the placebo than in the DHA intervention group had a visual acuity below average ( P = 0.048 ) . Maternal red blood cell ethanolamine phosphoglyceride docosatetraenoic acid was inversely related to visual acuity in boys ( rho = -0.37 , P < 0.05 ) and girls ( rho = -0.48 , P < 0.01 ) . CONCLUSIONS These studies suggest that some pregnant women in our study population were DHA-deficient BACKGROUND There are few studies reporting on docosahexaenoic acid ( DHA , 22:6n-3 ) supplementation during pregnancy and infant cognitive function . DHA supplementation in pregnancy and infant problem solving in the first year have not been investigated . OBJECTIVE We tested the hypothesis that infants born to women who consumed a DHA-containing functional food during pregnancy would demonstrate better problem-solving abilities and recognition memory than would infants born to women who consumed the placebo during pregnancy . DESIGN In a double-blind , placebo-controlled , r and omized trial , pregnant women consumed a DHA-containing functional food or a placebo from gestation week 24 until delivery . Study groups received DHA-containing cereal-based bars ( 300 mg DHA/92-kcal bar ; average consumption : 5 bars/wk ; n = 14 ) or cereal-based placebo bars ( n = 15 ) . The Infant Planning Test and Fagan Test of Infant Intelligence were administered to infants at age 9 mo . The problem-solving trial included a support step and a search step . The procedure was scored on the basis of the infant 's performance on each step and on the entire problem ( intention score 
    Output:
    