Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Asociación para la Prevención y Estudio del VIH/Sida, Retalhuleu 11001, Guatemala.
Nutrients. 2023 Apr 25;15(9):2062. doi: 10.3390/nu15092062.
Undernutrition and a lack of learning opportunities can jeopardize long-term growth and development among infants in low- and middle-income countries. We conducted a 6-month 2 × 2 cluster-randomized trial to assess the effects of multiple micronutrient-fortified beverages and responsive caregiving interventions among infants 6-18 months in 72 community sectors in southwest Guatemala. We administered baseline and endline assessments of childhood development (Bayley Scales of Infant and Toddler Development) and socioemotional development (Brief Infant Toddler Socio-Emotional Assessment) and measured ferritin and hemoglobin on a subsample. The trial was analyzed using linear mixed models. At the baseline, the mean age (SD) was 13.0 (4.6) months, including 49% males, 32% who were stunted, 55% who were anemic, and 58% who were iron deficient. At the endline ( = 328/386, 85% retention), there was no synergistic effect on the fortified beverage and responsive caregiving intervention. Compared to the non-fortified beverage group, socioemotional development improved in the fortified beverage group. There were no intervention effects on other measures of child development, hemoglobin, or ferritin. In a setting with high rates of anemia and iron deficiency, a multiple micronutrient-fortified beverage improved infants' socioemotional development.
在中低收入国家，营养不良和缺乏学习机会可能会危及婴儿的长期生长和发育。我们进行了一项为期 6 个月的 2×2 集群随机试验，以评估在危地马拉西南部 72 个社区部门中，6-18 个月大的婴儿中多种微量营养素强化饮料和响应式护理干预的效果。我们对儿童发育（贝利婴幼儿发育量表）和社会情感发育（简短婴幼儿社会情感评估）进行了基线和期末评估，并对亚样本进行了铁蛋白和血红蛋白测量。该试验使用线性混合模型进行分析。在基线时，平均年龄（SD）为 13.0（4.6）个月，包括 49%的男性，32%的发育迟缓，55%的贫血，58%的缺铁。在期末（=328/386，85%保留率），强化饮料和响应式护理干预之间没有协同作用。与非强化饮料组相比，强化饮料组的社会情感发育有所改善。在其他儿童发育、血红蛋白或铁蛋白测量方面，没有干预效果。在贫血和缺铁率较高的环境中，多种微量营养素强化饮料可改善婴儿的社会情感发育。
