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The Cognitive Link between in Utero Nutrition and Schooling: Experimental Evidence from Tanzania
Last registered on March 10, 2014

Pre-Trial

Trial Information
General Information
Title
The Cognitive Link between in Utero Nutrition and Schooling: Experimental Evidence from Tanzania
RCT ID
AEARCTR-0000145
Initial registration date
March 10, 2014
Last updated
March 10, 2014 2:50 AM EDT
Location(s)
Primary Investigator
Affiliation
State University of New York (Binghamton) & Harvard University
Other Primary Investigator(s)
Additional Trial Information
Status
Completed
Start date
2002-11-15
End date
2013-09-01
Secondary IDs
Abstract
Because of the high returns of schooling in developing countries, policy-makers have placed considerable attention to increasing school access. However, an important mechanism through which brain development in utero can affect demand for education exists. Cognitive development in utero, due to maternal deficiency in folic acid, can biologically constrain children’s demand for education. Using a more scientifically credible research designed to detect causal effects than has been used in previous research, we examine how reductions in micronutrient deficiency in utero impact subsequent child schooling attainment in Tanzania. We also examine to what extent parents allocate resources so as to compensate for or to reinforce inequalities across children in cognitive endowments. Capturing the behavioral response to the biological intervention allows us to disentangle the biological effect from the household response to the original randomized intervention. To execute this strategy, we follow up on a randomized control trial with micronutrient supplements offered to HIV-negative pregnant women in Dar es Salaam, Tanzania between 2001-2003. While data collection is still ongoing, very preliminary results show cognitive improvements among children born to mothers in the micronutrient supplementation group from the original RCT.
External Link(s)
Registration Citation
Citation
Nikolov, Plamen. 2014. "The Cognitive Link between in Utero Nutrition and Schooling: Experimental Evidence from Tanzania." AEA RCT Registry. March 10. https://doi.org/10.1257/rct.145-3.0.
Former Citation
Nikolov, Plamen. 2014. "The Cognitive Link between in Utero Nutrition and Schooling: Experimental Evidence from Tanzania." AEA RCT Registry. March 10. https://www.socialscienceregistry.org/trials/145/history/1280.
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
The double-blind trial, assigning 8468 pregnant women to receive a daily oral dose of either a micronutrient supplement or placebo, examined the effect of nutrient supplementation on low birth weight (<2500g), prematurity, and fetal death. The randomized trial started between 2001-2004 with pregnant women in Dar es Salaam, Tanzania to account for differences in physical health outcomes at birth for children. Pregnant women who attended antenatal clinicsAccording to a DHS 1996 (Bureau of Statistics, 1996), 97% of pregnant women attend antenatal care (ANC), and 70% do so at least four times. in Dar es Salaam, Tanzania, between August 2001 and July 2004 were invited to participate in the trial. Simple random sampling was used. Requirements for eligibility included a negative test for HIV infection, a plan to stay in the city until delivery and for 1 year thereafter, and an estimated gestational age between 6 and 27 weeks according to the date of the last menstrual period. A list was prepared according to a randomization sequence in blocks of 20; at enrollment, each eligible woman was assigned to the next numbered bottle. The treatment tablet included 20 mg of micronutrient B2, 25 mg of micronutrient B6, 50 mg of micronutrient B12, and 0.8 mg of B9 (folic acid).The active tablets and placebo were similar in shape, size, and color and were packaged in identical coded bottles.Average take up rate of treatment in the original RCT was 0.88.
Intervention Start Date
2002-11-15
Intervention End Date
2013-09-01
Primary Outcomes
Primary Outcomes (end points)
health status at birth;
health status within first 6 months;
cognitive outcomes for children for children born to mothers who participated in the RCT between 2001-2004;
non-cognitive outcomes for children for children born to mothers who participated in the RCT between 2001-2004
parental investments after children's birth
educational status for for children born to mothers who participated in the RCT between 2001-2004;
labor market outcomes for families who had a member participating in the RCT between 2001-2004;
Primary Outcomes (explanation)
n/a
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The double-blind trial, assigning 8468 pregnant women to receive a daily oral dose of either a micronutrient supplement or placebo, examined the effect of nutrient supplementation on low birth weight (<2500g), prematurity, and fetal death. The randomized trial started between 2001-2004 with pregnant women in Dar es Salaam, Tanzania to account for differences in physical health outcomes at birth for children. Pregnant women who attended antenatal clinicsAccording to a DHS 1996 (Bureau of Statistics, 1996), 97% of pregnant women attend antenatal care (ANC), and 70% do so at least four times. in Dar es Salaam, Tanzania, between August 2001 and July 2004 were invited to participate in the trial. Simple random sampling was used. Requirements for eligibility included a negative test for HIV infection, a plan to stay in the city until delivery and for 1 year thereafter, and an estimated gestational age between 6 and 27 weeks according to the date of the last menstrual period. A list was prepared according to a randomization sequence in blocks of 20; at enrollment, each eligible woman was assigned to the next numbered bottle. The treatment tablet included 20 mg of micronutrient B2, 25 mg of micronutrient B6, 50 mg of micronutrient B12, and 0.8 mg of B9 (folic acid).The active tablets and placebo were similar in shape, size, and color and were packaged in identical coded bottles.Average take up rate of treatment in the original RCT was 0.88.
Experimental Design Details
Randomization Method
block randomization
Randomization Unit
individual
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
8468 individuals
Sample size: planned number of observations
8468
Sample size (or number of clusters) by treatment arms
4234 in treatment group; 4234 in control group.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials

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IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Harvard University CUHS
IRB Approval Date
2011-11-01
IRB Approval Number
F19899-122
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
Yes
Intervention Completion Date
September 01, 2013, 12:00 AM +00:00
Is data collection complete?
Yes
Data Collection Completion Date
Final Sample Size: Number of Clusters (Unit of Randomization)
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
Final Sample Size (or Number of Clusters) by Treatment Arms
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports and Papers
Preliminary Reports
Relevant Papers