Abstract
Obtaining a nutrient-rich diet during pregnancy is a challenge for pregnant women living in low-income countries. This randomized, controlled trial was designed to determine if a freshly prepared food supplement from local animal-source foods and dark-green leafy vegetables given prior to and/or during pregnancy improved birth outcomes in rural Vietnamese women. Primiparous women, 18 to 30 years of age, who participated in the study were assigned to one of three groups: PC-T women received the supplement from pre-conception to term, MG-T women received the supplement from mid-gestation to term, and the RPC women received routine prenatal care. Supplement intake was observed and quantified. Infant anthropometry was measured at birth and/or within seven days of delivery. The effect of the intervention on maternal and birth outcomes was determined using linear regression modeling. Of the 460 women enrolled in the study, 317 women completed the study. Those not completing the study had either moved from the area, did not conceive within 12 months of study enrollment, or miscarried. The food-based supplement increased protein, iron, zinc, folate, vitamin A and B12 intakes in the PC-T and the MG-T groups. However, it failed to alter infant anthropometric measurements at birth. In the entire cohort, maternal gestational weight gain was greater in women with a low pre-pregnancy BMI (<18.5) and in women with a higher educational attainment. Working as a farmer reduced gestational weight gain but it did not affect birth weight or length. In summary, a nutrient-rich, food-based supplement given to rural Vietnamese women from pre-conception to term or mid-gestation to term did not affect maternal or infant outcomes. The low weight gains, possibly due to demanding farm work done throughout the reproductive cycle, may have obviated any effects of the low energy, nutrient-rich food supplement on birth outcomes.Trial registration : Registered Clinical Trials.gov: NCT01235767.
Highlights
Infants may have a low birth weight because they were born too soon or were growth restricted in utero
Poor maternal nutrition is linked to both prematurity and fetal growth retardation
Women were excluded if they tested positive for pregnancy, if they had a history of illness such as HIV, tuberculosis, malaria, diabetes, heart or kidney diseases, if they had delivered a previous child, if they had a body mass index (BMI)
Summary
Infants may have a low birth weight because they were born too soon (premature) or were growth restricted in utero. Poor maternal nutrition is linked to both prematurity and fetal growth retardation. Indicators of maternal malnutrition before pregnancy, such as short stature, account for about one third of low weight births [1]. Previous research shows that the nutritional status of the mother at conception is a key factor affecting fetal growth and pre-term deliveries [4,5,6]. This observation is verified by animal studies reporting that maternal nutrient deficiencies during the first weeks of pregnancy are linked to poor fetal growth [7]. Maternal diet at conception influences placental development and subsequent fetal growth [8]
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