Lipid‐based nutrient supplements for pregnant women reduce newborn stunting in Bangladesh (256.6)

Abstract

Maternal undernutrition and newborn stunting (birth length‐for‐age z‐score < ‐2) are common in Bangladesh. In the Rang‐Din Nutrition Study, a cluster‐randomized effectiveness trial underway in northwest Bangladesh, pregnant women received either a) iron & folic acid (IFA) or b) lipid‐based nutrient supplement (LNS, 20 g/d, 118 kcal) designed to enrich local diets of pregnant women with essential fatty acids, high‐quality protein and 22 micronutrients. Women (n=4011) were enrolled at 13.1 ± 3.4 wk gestation; 40% were nulliparous and 31% were underweight (BMI < 18.5 kg/m2). In the full sample, there were significant reductions in newborn stunting [18.6 vs. 22.5%, adjusted relative risk (ARR)=0.83 (0.70, 0.96)] and small head circumference (HC z‐score < ‐2) [20.8 vs. 24.7%, ARR=0.82 (0.71, 0.95)] in the LNS vs. IFA group; the difference in low birth weight was marginally significant (36.8 vs. 39.1%, p=0.087). LNS distribution was interrupted for 10 wk in 2012; among women who gave birth before the interruption, the rates of newborn stunting and small HC in LNS vs. IFA were 16.1 vs. 23.0% [ARR=0.66 (0.50, 0.87)] and 20.9 vs. 27.3% [ARR=0.73 (0.57, 0.91)], respectively. The effects of LNS on newborn stunting were greatest in women with household food insecurity and in those 14‐24 y of age. We conclude that LNS can improve birth outcomes in Bangladeshi women, especially those at higher risk for fetal growth restriction.Grant Funding Source: Supported by USAID through the Food and Nutrition Technical Assistance III Project (FANTA)