Effect of multiple micronutrient supplementation on the neurodevelopment of HIV‐exposed Tanzanian infants

Abstract

BackgroundMicronutrient deficiencies are common in sub‐Saharan Africa and are associated with impaired infant neurodevelopment. Exposure to HIV in utero may also adversely affect neurodevelopment.ObjectiveTo evaluate the effect of daily multiple micronutrient supplementation on the neurodevelopment of HIV‐exposed Tanzanian infants.MethodsInfants were randomized to receive daily oral supplementation of multiple micronutrients (vitamins B complex, C, and E) or placebo from 6 weeks of age for 24 months. The Bayley Scales of Infant Development, 3rd edition (BSID‐III) were administered a subset of 192 infants at age 15 mo. Multivariate regression models were used to compare the difference in scores between treatment groups.ResultsThe prevalences of male sex, preterm birth, and low birthweight were 52.6%, 16.2%, and 5.2%, respectively. After adjusting for sex and BSID‐III administrator, there were no significant differences in raw cognitive, gross motor, expressive or receptive language scores. There was a trend toward improved fine motor skills among infants in the micronutrient group (difference in means = 0.38; 95% CI = −0.01, 0.78; p=0.06).ConclusionsDaily multivitamins did not significantly improve the neurodevelopment of HIV‐exposed infants. Alternative strategies to improve child development should be explored in the context of HIV.