Advanced search
1 file | 189.99 KB

Impact of prenatal multiple micronutrients on survival and growth during infancy: a randomized controlled trial

Author
Organization
Abstract
Background: Although prenatal multiple micronutrients can improve fetal growth, their benefit on postnatal health remains uncertain. Objective: We assessed the effect of the UNICEF/WHO/United Nations University multiple micronutrient supplement for pregnant and lactating women (UNIMMAP) compared with the usual iron and folic acid supplement (IFA) on survival, growth, and morbidity during infancy. Design: In a double-blind, randomized trial, we followed 1294 singleton newborns whose mothers had prenatally received either the UNIMMAP or IFA. We assessed monthly anthropometric measures and health variables up to age 12 mo. Children were assessed again at a mean age of 30 mo. Mixed-effects models accounted for repeated measurements. Results: The UNIMMAP resulted in a 27% (HR: 0.73; 95% CI: 0.60, 0.87; P = 0.002) reduction in the rate of stunting in 15,261 infant-months with a higher length-for-age z score of 0.13 (95% CI: 0.02, 0.24; P = 0.02) over the whole observation period. However, by age 30 mo, this difference was not observed. An effect of the UNIMMAP on weight-for-length (P-interaction = 0.004) and head circumference for-age (P-interaction = 0.03) became apparent by the end of the first year of life. By the age of 30 mo, children from the UNIMMAP group had a higher weight-for-height z score of 0.20 (95% CI: 0.06, 0.34; P = 0.004). No difference in mortality or morbidity was identified in groups, except a 14% reduction in reported episodes of fever (95% CI: 1%, 28%; P = 0.04). Conclusions: Improved linear fetal growth with continuation into early life and enhanced postnatal growth were 2 mechanisms that mediated the effect of the prenatal UNIMMAP on infant nutritional status. Additional follow-up to assess long-term effects is warranted. This trial was registered at clinicaltrials.gov as NCT00642408.
Keywords
BLOOD-PRESSURE, PREGNANCY, PERINATAL-MORTALITY, LINEAR GROWTH, ZINC SUPPLEMENTATION, BIRTH-WEIGHT, FOLIC-ACID SUPPLEMENTATION, DOUBLE-BLIND, FETAL, IRON

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 189.99 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Roberfroid, Dominique, Lieven Huybregts, Hermann Biénou Lanou, Laetitia Ouedraogo, Marie-Claire Henry, Nicolas Meda, and Patrick Kolsteren. 2012. “Impact of Prenatal Multiple Micronutrients on Survival and Growth During Infancy: a Randomized Controlled Trial.” American Journal of Clinical Nutrition 95 (4): 916–924.
APA
Roberfroid, D., Huybregts, L., Lanou, H. B., Ouedraogo, L., Henry, M.-C., Meda, N., & Kolsteren, P. (2012). Impact of prenatal multiple micronutrients on survival and growth during infancy: a randomized controlled trial. AMERICAN JOURNAL OF CLINICAL NUTRITION, 95(4), 916–924.
Vancouver
1.
Roberfroid D, Huybregts L, Lanou HB, Ouedraogo L, Henry M-C, Meda N, et al. Impact of prenatal multiple micronutrients on survival and growth during infancy: a randomized controlled trial. AMERICAN JOURNAL OF CLINICAL NUTRITION. 2012;95(4):916–24.
MLA
Roberfroid, Dominique, Lieven Huybregts, Hermann Biénou Lanou, et al. “Impact of Prenatal Multiple Micronutrients on Survival and Growth During Infancy: a Randomized Controlled Trial.” AMERICAN JOURNAL OF CLINICAL NUTRITION 95.4 (2012): 916–924. Print.
@article{2130535,
  abstract     = {Background: Although prenatal multiple micronutrients can improve fetal growth, their benefit on postnatal health remains uncertain. 
Objective: We assessed the effect of the UNICEF/WHO/United Nations University multiple micronutrient supplement for pregnant and lactating women (UNIMMAP) compared with the usual iron and folic acid supplement (IFA) on survival, growth, and morbidity during infancy. 
Design: In a double-blind, randomized trial, we followed 1294 singleton newborns whose mothers had prenatally received either the UNIMMAP or IFA. We assessed monthly anthropometric measures and health variables up to age 12 mo. Children were assessed again at a mean age of 30 mo. Mixed-effects models accounted for repeated measurements. 
Results: The UNIMMAP resulted in a 27\% (HR: 0.73; 95\% CI: 0.60, 0.87; P = 0.002) reduction in the rate of stunting in 15,261 infant-months with a higher length-for-age z score of 0.13 (95\% CI: 0.02, 0.24; P = 0.02) over the whole observation period. However, by age 30 mo, this difference was not observed. An effect of the UNIMMAP on weight-for-length (P-interaction = 0.004) and head circumference for-age (P-interaction = 0.03) became apparent by the end of the first year of life. By the age of 30 mo, children from the UNIMMAP group had a higher weight-for-height z score of 0.20 (95\% CI: 0.06, 0.34; P = 0.004). No difference in mortality or morbidity was identified in groups, except a 14\% reduction in reported episodes of fever (95\% CI: 1\%, 28\%; P = 0.04). 
Conclusions: Improved linear fetal growth with continuation into early life and enhanced postnatal growth were 2 mechanisms that mediated the effect of the prenatal UNIMMAP on infant nutritional status. Additional follow-up to assess long-term effects is warranted. This trial was registered at clinicaltrials.gov as NCT00642408.},
  author       = {Roberfroid, Dominique and Huybregts, Lieven and Lanou, Hermann Bi{\'e}nou and Ouedraogo, Laetitia and Henry, Marie-Claire and Meda, Nicolas and Kolsteren, Patrick},
  issn         = {0002-9165},
  journal      = {AMERICAN JOURNAL OF CLINICAL NUTRITION},
  language     = {eng},
  number       = {4},
  pages        = {916--924},
  title        = {Impact of prenatal multiple micronutrients on survival and growth during infancy: a randomized controlled trial},
  url          = {http://dx.doi.org/10.3945/ajcn.111.029033},
  volume       = {95},
  year         = {2012},
}

Altmetric
View in Altmetric
Web of Science
Times cited: