Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Department of Human Nutrition and Home Economics, Kyambogo University, Kampala, Uganda.
Matern Child Nutr. 2018 Apr;14(2):e12527. doi: 10.1111/mcn.12527. Epub 2017 Sep 19.
Stunting is associated with impaired cognitive and motor function. The effect of an education intervention including nutrition, stimulation, sanitation, and hygiene on child growth and cognitive/language/motor development, delivered to impoverished mothers in Uganda, was assessed. In a community-based, open cluster-randomized trial, 511 mother/children dyads aged 6-8 months were enrolled to an intervention (n = 263) or control (n = 248) group. The primary outcome was change in length-for-age z-score at age 20-24 months. Secondary outcomes included anthropometry and scores on the 2 developmental scales: Bayley Scales of Infant and Toddler Development-III and the Ages and Stages Questionnaire. There was no evidence of a difference in mean length-for-age z-score at 20-24 months between the 2 study groups: 0.10, 95% CI [-0.17, 0.36], p = .49. The intervention group had higher mean composite development scores than the controls on Bayley Scales of Infant and Toddler Development-III, the mean difference being 15.6, 95% CI [10.9, 20.2], p = .0001; 9.9, 95% CI [6.4, 13.2], p = .0001; and 14.6, 95% CI [10.9, 18.2], p = .0001, for cognitive, language, and motor composite scores, respectively. The mean difference in scores from the Ages and Stages Questionnaire were 7.0, 95% CI [2.9, 11.3], p = .001; 5.9, 95% CI [1.2, 10.3], p = .01; 4.2, 95% CI [1.7, 6.7], p = .001; 8.9, 95% CI [5.3, 12.3], p = .0001; and 4.4, 95% CI [0.0, 8.8], p = .05, for communication, gross motor, fine motor, problem solving, and personal-social development, respectively. The intervention education delivered to mothers promoted early development domains in cognitive, language, and motor development but not linear growth of small children in impoverished rural communities in Uganda. Our study showed that child development may be improved with a relatively low cost intervention strategy. This trial was registered at ClinicalTrials.gov as NCT02098031.
发育迟缓与认知和运动功能受损有关。评估了在乌干达贫困母亲中实施的一项包括营养、刺激、卫生和卫生教育干预措施对儿童生长和认知/语言/运动发育的影响，该干预措施针对的是营养、刺激、卫生和卫生。在一项基于社区的、开放的集群随机试验中，511 对 6-8 个月大的母婴对被纳入干预（n=263）或对照（n=248）组。主要结局是 20-24 个月时年龄-身高 z 评分的变化。次要结局包括人体测量学和 2 个发育量表的评分：贝利婴幼儿发育量表第三版和年龄与阶段问卷。两组之间 20-24 个月时的平均年龄-身高 z 评分无差异：0.10，95%置信区间[-0.17，0.36]，p=0.49。干预组在贝利婴幼儿发育量表第三版上的综合发育评分高于对照组，平均差异为 15.6，95%置信区间[10.9，20.2]，p=0.0001；9.9，95%置信区间[6.4，13.2]，p=0.0001；和 14.6，95%置信区间[10.9，18.2]，p=0.0001，分别为认知、语言和运动综合评分。年龄与阶段问卷的评分平均差异为 7.0，95%置信区间[2.9，11.3]，p=0.001；5.9，95%置信区间[1.2，10.3]，p=0.01；4.2，95%置信区间[1.7，6.7]，p=0.001；8.9，95%置信区间[5.3，12.3]，p=0.0001；和 4.4，95%置信区间[0.0，8.8]，p=0.05，分别为沟通、大运动、精细运动、解决问题和个人-社会发展。向母亲提供的干预教育促进了认知、语言和运动发育等早期发育领域的发展，但并未改善乌干达贫困农村社区幼儿的线性生长。我们的研究表明，儿童发育可以通过相对低成本的干预策略得到改善。该试验在 ClinicalTrials.gov 注册为 NCT02098031。
