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 OBJECTIVE : To determine the impact of iron deficiency anemia ( IDA ) in pregnancy on young child development . METHODS : A 2-year follow-up of 850 children born to women who participated in a double-blind cluster r and omized controlled trial of prenatal micronutrient supplementation in western rural China . These women were r and omly assigned to receive either daily folic acid , iron/folic acid ( 60 mg iron ) , or multiple micronutrients ( with 30 mg iron ) during pregnancy . Children were categorized into the prenatal-IDA and prenatal – non-IDA groups based on the mother ’s hemoglobin in the third trimester . Each group contained 3 subgroups based on mother ’s treatment : folic acid , iron/folic acid , and multiple micronutrients .  Bayley scales of infant development were administered to the children to assess their development at 3 , 6 , 12 , 18 , and 24 months of age . RESULTS : Compared with the prenatal – non-IDA group , the prenatal-IDA group showed a significantly lower mental development index at 12 , 18 , and 24 months of age . The adjusted mean difference was 5.8 ( 95 % confidence interval [ CI ] , 1.1–10.5 ) , 5.1 ( 95 % CI , 1.2–9.0 ) , and 5.3 ( 95 % CI , 0.9–9.7 ) , respectively . Further analysis showed that the mental development indexes in the prenatal-IDA group and prenatal – non-IDA group were similar with supplementation of iron/folic acid but were significantly lower in the prenatal-IDA group with supplementation of folic acid or multiple micronutrients . CONCLUSIONS : Prenatal IDA in the third trimester is associated with mental development of the child . However , prenatal supplementation with sufficient iron protects child development even when the woman ’s IDA was not properly corrected in pregnancy CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 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 The Cambridge Study in Delinquent Development is a prospect i ve longitudinal survey of 411 London males from ages 8 years old to 32 years old . This article investigates the prediction of  adolescent aggression  ( ages 12 - 14 years old ) ,  teenage violence  ( ages 16 - 18 years old ) ,  adult violence  ( age 32 years old ) , and  convictions for violence .  Generally , the best predictors were measures of economic deprivation , family criminality , poor child-rearing , school failure , hyperactivity-impulsivity-attention deficit , and antisocial child behavior . Similar predictors applied to all four measures of aggression and violence . It is concluded that aggression and violence are elements of a more general antisocial tendency , and that the predictors of aggression and violence are similar to the predictors of antisocial and criminal behavior in general BACKGROUND Childhood undernutrition may have prenatal origins , and the impact of prenatal interventions on postnatal growth is not well known . OBJECTIVE We assessed the effects of prenatal multiple micronutrient ( MM ) supplementation on child growth and cognitive development . DESIGN In a cluster-r and omized controlled trial in rural Bangladesh , prenatal MM supplementation compared with iron-folic acid ( IFA ) supplementation was examined for its impact on growth assessed longitudinally from birth up to 24 mo of age ( n = 8529 ) and , in a sub sample ( n = 734 ) , on cognitive function at 24 mo of age by use of the Bayley scales of infant and toddler development-third edition test . RESULTS Prevalence of stunting at birth [ length for age z score ( LAZ ) : < -2 ] was 31.9 % in the MM and 35.7 % in the IFA groups ( P < 0.001 ) ; however , LAZ increased during the first 3 - 4 mo in both groups . With the use of a linear r and om-effects model , prenatal MM-exposed children sustained a higher mean predicted LAZ of ∼0.10 at 1 and 3 mo and 0.06 at 6 mo of age compared with children in the IFA group . Supplementation reduced the prevalence of stunting at 1 ( RR : 0.95 ; 95 % CI : 0.92 , 0.98 ) and 3 ( RR : 0.91 ; 95 % CI : 0.88 , 0.94 ) mo of age . Differences between groups were absent by 6 , 12 , and 24 mo of age , when nearly 50 % of children had stunted growth . Ponderal and linear growth velocities were somewhat slower from 3 to 12 mo of age in the MM group than in the IFA group , but not from 12 to 24 mo of age . There was no difference between groups on composite scores of cognition , language , and motor performance at 24 mo of age . CONCLUSIONS In this Bangladeshi trial , maternal pre- and postnatal MM supplementation result ed in improvements in LAZ and reduction in stunting through 3 mo of age , but not thereafter and had no impact on cognitive and motor function at 2 y. This trial was registered at clinical trials.gov as NCT000860470 Background DHA is accumulated in the central nervous system ( CNS ) before birth and is involved in early developmental processes , such as neurite outgrowth and gene expression . Objective To determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants . Design A 
    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 OBJECTIVE : To determine the impact of iron deficiency anemia ( IDA ) in pregnancy on young child development . METHODS : A 2-year follow-up of 850 children born to women who participated in a double-blind cluster r and omized controlled trial of prenatal micronutrient supplementation in western rural China . These women were r and omly assigned to receive either daily folic acid , iron/folic acid ( 60 mg iron ) , or multiple micronutrients ( with 30 mg iron ) during pregnancy . Children were categorized into the prenatal-IDA and prenatal – non-IDA groups based on the mother ’s hemoglobin in the third trimester . Each group contained 3 subgroups based on mother ’s treatment : folic acid , iron/folic acid , and multiple micronutrients .  Bayley scales of infant development were administered to the children to assess their development at 3 , 6 , 12 , 18 , and 24 months of age . RESULTS : Compared with the prenatal – non-IDA group , the prenatal-IDA group showed a significantly lower mental development index at 12 , 18 , and 24 months of age . The adjusted mean difference was 5.8 ( 95 % confidence interval [ CI ] , 1.1–10.5 ) , 5.1 ( 95 % CI , 1.2–9.0 ) , and 5.3 ( 95 % CI , 0.9–9.7 ) , respectively . Further analysis showed that the mental development indexes in the prenatal-IDA group and prenatal – non-IDA group were similar with supplementation of iron/folic acid but were significantly lower in the prenatal-IDA group with supplementation of folic acid or multiple micronutrients . CONCLUSIONS : Prenatal IDA in the third trimester is associated with mental development of the child . However , prenatal supplementation with sufficient iron protects child development even when the woman ’s IDA was not properly corrected in pregnancy CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 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 The Cambridge Study in Delinquent Development is a prospect i ve longitudinal survey of 411 London males from ages 8 years old to 32 years old . This article investigates the prediction of  adolescent aggression  ( ages 12 - 14 years old ) ,  teenage violence  ( ages 16 - 18 years old ) ,  adult violence  ( age 32 years old ) , and  convictions for violence .  Generally , the best predictors were measures of economic deprivation , family criminality , poor child-rearing , school failure , hyperactivity-impulsivity-attention deficit , and antisocial child behavior . Similar predictors applied to all four measures of aggression and violence . It is concluded that aggression and violence are elements of a more general antisocial tendency , and that the predictors of aggression and violence are similar to the predictors of antisocial and criminal behavior in general BACKGROUND Childhood undernutrition may have prenatal origins , and the impact of prenatal interventions on postnatal growth is not well known . OBJECTIVE We assessed the effects of prenatal multiple micronutrient ( MM ) supplementation on child growth and cognitive development . DESIGN In a cluster-r and omized controlled trial in rural Bangladesh , prenatal MM supplementation compared with iron-folic acid ( IFA ) supplementation was examined for its impact on growth assessed longitudinally from birth up to 24 mo of age ( n = 8529 ) and , in a sub sample ( n = 734 ) , on cognitive function at 24 mo of age by use of the Bayley scales of infant and toddler development-third edition test . RESULTS Prevalence of stunting at birth [ length for age z score ( LAZ ) : < -2 ] was 31.9 % in the MM and 35.7 % in the IFA groups ( P < 0.001 ) ; however , LAZ increased during the first 3 - 4 mo in both groups . With the use of a linear r and om-effects model , prenatal MM-exposed children sustained a higher mean predicted LAZ of ∼0.10 at 1 and 3 mo and 0.06 at 6 mo of age compared with children in the IFA group . Supplementation reduced the prevalence of stunting at 1 ( RR : 0.95 ; 95 % CI : 0.92 , 0.98 ) and 3 ( RR : 0.91 ; 95 % CI : 0.88 , 0.94 ) mo of age . Differences between groups were absent by 6 , 12 , and 24 mo of age , when nearly 50 % of children had stunted growth . Ponderal and linear growth velocities were somewhat slower from 3 to 12 mo of age in the MM group than in the IFA group , but not from 12 to 24 mo of age . There was no difference between groups on composite scores of cognition , language , and motor performance at 24 mo of age . CONCLUSIONS In this Bangladeshi trial , maternal pre- and postnatal MM supplementation result ed in improvements in LAZ and reduction in stunting through 3 mo of age , but not thereafter and had no impact on cognitive and motor function at 2 y. This trial was registered at clinical trials.gov as NCT000860470 Background DHA is accumulated in the central nervous system ( CNS ) before birth and is involved in early developmental processes , such as neurite outgrowth and gene expression . Objective To determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants . Design A 
    Output:
    