Abstract
BackgroundLimited data is available on the role of prenatal nutritional status on the health of school-age children. We aimed to determine the impact of maternal micronutrient supplementation on the health status of Bangladeshi children.MethodsChildren (8.6–9.6 years; n = 540) were enrolled from a longitudinal mother-child cohort, where mothers were supplemented daily with either 30mg iron and 400μg folic acid (Fe30F), or 60mg iron and 400μg folic acid (Fe60F), or Fe30F including 15 micronutrients (MM), in rural Matlab. Blood was collected from children to determine the concentration of hemoglobin (Hb) and several micronutrients. Anthropometric and Hb data from these children were also available at 4.5 years of age and mothers at gestational week (GW) 14 and 30.ResultsMM supplementation significantly improved (p≤0.05) body mass index-for-age z-score (BAZ), but not Hb levels, in 9 years old children compared to the Fe30F group. MM supplementation also reduced markers of inflammation (p≤0.05). About 28%, 35% and 23% of the women were found to be anemic at GW14, GW30 and both time points, respectively. The prevalence of anemia was 5% and 15% in 4.5 and 9 years old children, respectively. The adjusted odds of having anemia in 9 year old children was 3-fold higher if their mothers were anemic at both GW14 and GW30 [Odds Ratio (OR) = 3.05; 95% Confidence Interval (CI) 1.42, 6.14, P = 0.002] or even higher if they were also anemic at 4.5 years of age [OR = 5.92; 95% CI 2.64, 13.25; P<0.001].ConclusionMaternal micronutrient supplementation imparted beneficial effects on child health. Anemia during pregnancy and early childhood are important risk factors for the occurrence of anemia in school-age children.
Highlights
A growing body of evidence indicates that the nutritional background of a woman during pregnancy and especially during early life is a critical determinant of her offspring’s subsequent health outcomes such as sub-optimum growth and mortality, suggesting an intergenerational transfer of poor health from mother to child [1,2]
MM supplementation significantly improved (p0.05) body mass index-for-age z-score (BAZ), but not Hb levels, in 9 years old children compared to the Fe30F group
About 28%, 35% and 23% of the women were found to be anemic at GW14, GW30 and both time points, respectively
Summary
A growing body of evidence indicates that the nutritional background of a woman during pregnancy and especially during early life is a critical determinant of her offspring’s subsequent health outcomes such as sub-optimum growth and mortality, suggesting an intergenerational transfer of poor health from mother to child [1,2]. The underlying cause of about 60% of childhood death below 5 years of age in Bangladesh is malnutrition which involves both calorie and micronutrient deficiencies [3]. In this age-group children suffer from one or more forms of malnutrition including stunting (32%), underweight (30%) and anemia (33%) [4]. Iron deficiency and iron deficiency anemia is a major public health problem worldwide, mostly in pregnant women, infants, and young children in developing countries [5] It adversely affects some vital aspects of human health, including poor cognitive development, decreased immune function and work productivity [5,6,7]. We aimed to determine the impact of maternal micronutrient supplementation on the health status of Bangladeshi children
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