President's Oral Session: Abstracts of Distinction

(OR14-05-25) Sustained Effects of Maternal Plus Child SQ-LNS in Early Life on Growth and Development Outcomes at Preschool Age Are Evident Among Females but Not Males in Ghana and Bangladesh

Monday, June 2, 2025

10:48 AM – 11:00 AM ET

Location: S230 CD

Presenting Author(s)

Kathryn G. Dewey, PhD (she/her/hers)

Distinguished Professor Emerita
University of California, Davis
Davis, California, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

CA

Charles D. Arnold, MS

Statistician
University of California, Davis
Davis, California, United States
Susana Matias, PhD (she/her/hers)

Assistant Professor
University of California, Berkeley
Berkeley, California, United States
Seth Adu-Afarwuah, Ph.D. (he/him/his)

Head of Department of Nutrition and Food Science
University of Ghana
Accra, Greater Accra, Ghana
MM

Malay K. Mridha, MBBS, MSc, MPH, PhD

Associate Professor
Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University
Dhaka, Dhaka, Bangladesh
SK

Sika M. Kumordzie, PhD

Postdoctoral Scholar
University of California, Davis
Kansas City, Missouri, United States
MD

Maku E. Demuyakor, Ph.D

McKing Consulting Corporation
Smryna, Georgia, United States
FT

Fahmida Tofail, MD, PhD

International Centre for Diarrhoeal Disease Research, Bangladesh, icddrb
Dhaka, Dhaka, Bangladesh
BO

Brietta M. Oaks, PhD, MPH

University of Rhode Island
Kingston, Rhode Island, United States
HO

Harriet Eyram Okronipa, PhD

Assistant Professor, Department of Nutritional Sciences
Oklahoma State University
Stillwater, Oklahoma, United States

Objectives: We aimed to 1) examine whether there are sustained effects on growth or development at preschool age among children who were exposed to both maternal and child small-quantity lipid-based nutrient supplements (SQ-LNS) in early life, and 2) examine whether the effects of SQ-LNS in early life differ between male and female children.

Methods: We conducted a two-stage individual participant data meta-analysis of two randomized controlled trials that provided SQ-LNS during both pregnancy and infancy (starting at 6 mo and continuing to 18-24 mo of age) and followed up the cohorts after 36 mo of age with assessments of growth and development: the iLiNS-DYAD trial in Ghana and the Rang-Din Nutrition Study in Bangladesh. Growth outcomes included weight-for-age z-score (WAZ), height-for-age z-score (HAZ) and several indicators of body composition. Development outcomes assessed in both sites included language, visual-spatial, executive function, and pre-academic skills.

Results: In the overall sample (n=3565 across both trials), small main effects were evident for WAZ (mean difference (95% confidence interval): +0.06 (0.01, 0.11)) and HAZ (+0.05 (-0.01, 0.12)), compared to children not exposed to maternal or child SQ-LNS. Effects were of similar magnitude in both sites. There were no significant main effects on indicators of body composition or development. There were significant interaction effects by child sex for several outcomes, indicating positive effects among females (e.g., WAZ +0.16 (0.08, 0.24), HAZ +0.15 (0.06, 0.23), and language development z-score +0.12 (0.02, 0.22)) but no significant effects among males (WAZ -0.04 (-0.14, 0.05), HAZ -0.03 (-0.3, 0.08), language development -0.03 (-0.13, 0.08)).

Conclusions: We observed a sustained impact of prenatal plus postnatal SQ-LNS on growth and language development among female children, but not among males, at preschool age in two different countries. Further research is needed to investigate why there is a sex difference in response to nutrient supplementation in early life.

Funding Sources: USAID via the FANTA Project and the Bill & Melinda Gates Foundation