British Journal of Nutrition

Research Article

Mental and psychomotor development in Indonesian infants of mothers supplemented with vitamin A in addition to iron during pregnancy

Marjanka K. Schmidta1a2, Siti Muslimatuna1a2, Clive E. Westa1a3 c1, Werner Schultinka4 and Joseph G. A. J. Hautvasta1

a1 Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands

a2 SEAMEO TROPMED Regional Centre for Community Nutrition, University of Indonesia, Jakarta, Indonesia

a3 UNICEF, New York, USA

a4 Department of Gastroenterology, University Medical Centre Nijmegen, The Netherlands


Maternal nutrition is important for fetal development, but its impact on the functional outcome of infants is still unclear. The present study investigated the effects of vitamin A and Fe supplementation during gestation on infant mental and psychomotor development. Mothers of infants from five villages in Indonesia were randomly assigned to supervised, double-blind supplementation once per week from approximately 18 weeks of pregnancy until delivery. Supplementation comprised 120 mg Fe + 500 μg folic acid with (n 94) or without (n 94) 4800 μg retinol in the form of retinyl acetate. Mothers of infants who participated in the national Fe+folic acid supplementation programme, but whose intake of supplements was not supervised, were recruited from four other villages (n 88). The mental and psychomotor development of infants was assessed, either at 6 or 12 months of age, using the Bayley Scales of Infant Development (BSID). We found no impact of vitamin A supplementation on mental or psychomotor development of infants. In addition, infants whose mothers had received weekly Fe supplementation had similar mental and psychomotor indices as those whose mothers had participated in the governmental Fe supplementation programme. The study population was moderately Fe and vitamin A deficient. The size of the treatment groups was large enough to detect a mean difference of 10 points on the BSID, which is less than 1 sd (15 points) of the average performance of an infant on the BSID. In conclusion, the present study did not find an impact of weekly supplementation of 4800 RE vitamin A in addition to Fe during gestation on functional development of Indonesian infants. However, smaller improvements in development may be seen if studied in a larger and/or more deficient population.

(Received December 16 2002)

(Revised June 27 2003)

(Accepted October 07 2003)


c1 *Corresponding author: Professor Clive E. West, fax +31 317 483342, email