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The impact of maternal supplementation during pregnancy and the first 6 months postpartum on the growth status of the next child born after the intervention period: Follow-up results from Bangladesh and Ghana.

Published on Feb 5, 2020in Maternal and Child Nutrition3.305
· DOI :10.1111/MCN.12927
Katherine P. Adams5
Estimated H-index: 5
(UC Davis: University of California, Davis),
Seth Adu-Afarwuah12
Estimated H-index: 12
(University of Ghana)
+ 7 AuthorsKathryn G. Dewey68
Estimated H-index: 68
(UC Davis: University of California, Davis)
Sources
Abstract
Pregnancy and breastfeeding make demands on maternal nutrient stores. The extent of depletion and the degree to which nutrient stores are replenished between pregnancies has implications for a mother's nutritional status at conception of the subsequent child and therefore that child's birth outcomes and growth. Using follow-up data collected several years after a randomized effectiveness trial conducted in rural Bangladesh and a randomized efficacy trial conducted in semiurban Ghana, we evaluated the impact of maternal supplementation with small-quantity lipid-based nutrient supplements (LNS) or multiple micronutrients (MMN) through pregnancy (the index pregnancy) and 6 months postpartum on the growth status of the next living younger sibling conceived and born after the index pregnancy. In both Bangladesh (n = 472 younger siblings) and Ghana (n = 327 younger siblings), there were no overall differences in the growth status or the prevalence of undernutrition among younger siblings whose mothers had received LNS (or MMN, Ghana only) during and after the index pregnancy compared with the younger siblings of mothers who had received iron plus folic acid (IFA) during the index pregnancy (Ghana) or during and for 3 months after the index pregnancy (Bangladesh). These findings do not indicate that preconception nutrition interventions do not improve child growth. Rather, they suggest that any benefits of maternal LNS or MMN supplementation during one pregnancy and for 6 months postpartum are unlikely to extend to the growth of her next child beyond any effects due to IFA alone.
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References29
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#1K. Michael Hambidge (Anschutz Medical Campus)H-Index: 47
#2Jamie E Westcott (Anschutz Medical Campus)H-Index: 8
Last. Nancy F. Krebs (Anschutz Medical Campus)H-Index: 56
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Background: Reported benefits of maternal nutrition supplements commenced during pregnancy in low-resource populations have typically been quite limited. Objectives: This study tested the effects on newborn size, especially length, of commencing nutrition supplements for women in low-resource populations ≥3 mo before conception (Arm 1), compared with the same supplement commenced late in the first trimester of pregnancy (Arm 2) or not at all (control Arm 3). Methods: Women First was a 3-arm indi...
7 CitationsSource
4 CitationsSource
#1Susana L Matias (UC Davis: University of California, Davis)H-Index: 9
#2Malay K Mridha (BRACU: BRAC University)H-Index: 11
Last. Kathryn G. Dewey (UC Davis: University of California, Davis)H-Index: 12
view all 5 authors...
Background: Maternal anemia and iron deficiency are prevalent in low- and middle-income countries. Objective: We aimed to determine the effects of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on hemoglobin (Hb), anemia, and iron status (nonprimary outcomes) at 36 weeks of gestation (women) and 6 mo postpartum (women and infants). Methods: The Rang-Din Nutrition Study, a cluster-randomized effectiveness trial, enrolled 4011 Bangladeshi pregnant women at ≤20 weeks of ...
Source
#1Melissa Young (Emory University)H-Index: 9
#2Phuong Nguyen (IFPRI: International Food Policy Research Institute)H-Index: 19
Last. Usha Ramakrishnan (Emory University)H-Index: 41
view all 8 authors...
Growing evidence supports the role of preconception maternal nutritional status (PMNS) on birth outcomes; however, evidence of relationships with child growth are limited. We examined associations between PMNS (height, weight and body mass index- BMI) and offspring growth during the first 1000 days. We used prospective cohort data from a randomized-controlled trial of preconception micronutrient supplementation in Vietnam, PRECONCEPT (n = 1409). Poisson regression models were used to examine ass...
5 CitationsSource
#1Judith Stephenson (UCL: University College London)H-Index: 47
#2Nicola Heslehurst (Newcastle University)H-Index: 14
Last. Gita D. Mishra (UQ: University of Queensland)H-Index: 54
view all 14 authors...
Summary A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from low-income, middle-income, and high-income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours. Observational studies show strong links between he...
89 CitationsSource
#1Mary Barker (Southampton General Hospital)H-Index: 28
#2Stephan U Dombrowski (University of Stirling)H-Index: 22
Last. Judith Stephenson (UCL: University College London)H-Index: 47
view all 15 authors...
Summary The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring. Evidence of the effectiveness of preconception interventions for improving outcomes for mothers and babies is scarce. However, given the large potential health return, and relatively low costs and risk of harm, research into potential interventions is warranted. We identified three promising strategies for intervention that are lik...
42 CitationsSource
#1Seth Adu-Afarwuah (University of Ghana)H-Index: 12
#2Rebecca T Young (UC Davis: University of California, Davis)H-Index: 4
Last. Kathryn G. Dewey (UC Davis: University of California, Davis)H-Index: 68
view all 8 authors...
: There is little information on whether prenatal multiple micronutrient (MMN) supplements containing iodine affect women's iodine status. In the International Lipid-based Nutrient Supplements DYAD-Ghana trial, we aimed to assess women's urinary iodine concentration (UIC, μg/L) during pregnancy, as one of the planned secondary outcomes. Women (n = 1,320) <20 weeks of gestation were randomized to consume 60 mg iron and 400 μg folic acid per day (iron and folic acid [IFA]); 18 vitamins and mineral...
3 CitationsSource
#1Katherine P. AdamsH-Index: 5
#2Emmanuel Ayifah (University of the Witwatersrand)H-Index: 3
Last. Kathryn G. DeweyH-Index: 12
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Author(s): Adams, Katherine P; Ayifah, Emmanuel; Phiri, Thokozani E; Mridha, Malay K; Adu-Afarwuah, Seth; Arimond, Mary; Arnold, Charles D; Cummins, Joseph; Hussain, Sohrab; Kumwenda, Chiza; Matias, Susana L; Ashorn, Ulla; Lartey, Anna; Maleta, Kenneth M; Vosti, Stephen A; Dewey, Kathryn G | Abstract: Background: It is unknown whether self-reported measures of household food insecurity change in response to food-based nutrient supplementation.Objective: We assessed the impacts of providing lipid...
3 CitationsSource
#1Malay K Mridha (UC Davis: University of California, Davis)H-Index: 11
#2Susana L Matias (UC Davis: University of California, Davis)H-Index: 9
Last. Kathryn G. Dewey (UC Davis: University of California, Davis)H-Index: 68
view all 12 authors...
: Background: Maternal iodine deficiency during pregnancy and lactation is common in Bangladesh.Objective: We evaluated the effect of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on urinary iodine concentration (UIC).Methods: We conducted a cluster-randomized controlled effectiveness trial in which we enrolled 4011 pregnant women at ≤20 gestational weeks. Women in 48 clusters received iron and folic acid (IFA; 60 mg Fe/d + 400 μg folic acid/d) and women in 16 cluste...
4 CitationsSource
#1Phuong Nguyen (IFPRI: International Food Policy Research Institute)H-Index: 19
#2Ines Gonzalez-Casanova (Emory University)H-Index: 11
Last. Usha Ramakrishnan (Emory University)H-Index: 41
view all 10 authors...
: Background: Maternal health and nutrition play a crucial role in early child growth and development. However, little is known about the benefits of preconception micronutrient interventions beyond the role of folic acid (FA) and neural tube defects.Objective: We evaluated the impact of weekly preconception multiple micronutrient (MM) or iron and folic acid (IFA) supplementation on child growth and development through the age of 2 y compared with FA alone.Methods: We followed 1599 offspring bor...
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