Effects Of Antenatal Micronutrient Supplementation Research Articles

Effect of Antenatal Micronutrient Supplementation on Fetal Birth Weight

Effect of Antenatal Micronutrient Supplementation on Fetal Birth Weight

Maternal Prenatal Nutrition and Birth Outcomes on Malnutrition among 7- to 10-Year-Old Children: A 10-Year Follow-Up

To identify postnatal predictors of malnutrition among 7- to 10-year-old children and to assess the long-term effects of antenatal micronutrient supplementation on malnutrition. A follow-up study was conducted to assess the nutritional status of 7- to 10-year-olds (1747 children) whose mothers participated in a cluster-randomized double-blind controlled trial from 2002 to 2006. The rate of malnourished 7- to 10-year-olds was 11.1%. A mixed-effects logistic regression model adjusted for the cluster-sampling design indicated that mothers with low prepregnant midupper arm circumference had boys with an increased risk of thinness (aOR 2.05, 95% CI 1.11, 3.79) and girls who were more likely to be underweight (aOR 2.01, 95% CI 1.05, 3.85). Antenatal micronutrient supplementation was not significantly associated with malnutrition. Low birth weight was significantly associated with increased odds of malnutrition among boys (aOR 4.34, 95% CI 1.82, 10.39) and girls (aOR 7.50, 95% CI 3.48, 16.13). Being small for gestational age significantly increased the odds of malnutrition among boys (aOR 1.75, 95% CI 1.01, 3.04) and girls (aOR 4.20, 95% CI 2.39, 7.39). In addition, household wealth, parental height, being picky eater, and illness frequency also predicted malnutrition. Both maternal prenatal nutrition and adverse birth outcomes are strong predictors of malnutrition among early school-aged children. Currently, available evidence is insufficient to support long-term effects of antenatal micronutrient supplementation on children's nutrition. www.isrctn.com: ISRCTN08850194.

Effect of Antenatal Micronutrient Supplementation on the Plasma Proteome in School Aged Children in Nepal

Effect of Antenatal Micronutrient Supplementation on the Plasma Proteome in School Aged Children in Nepal

P04 The phenotypic effects of antenatal multiple micronutrient supplementation in Nepalese children

BackgroundA growing body of evidence suggests that changes in early-life environment can have lasting effects. To investigate this, we followed up children from a double-blind randomised controlled trial of antenatal...

Effects of Antenatal Micronutrient Supplementation on Plasma Protein Profiles in Nepalese Children

Antenatal multiple micronutrient (MN) supplementation in malnourished settings may favor a healthy phenotype in offspring, but mechanisms remain largely unexplored. Plasma proteomics may offer a way to reveal long‐term metabolic effects of early MN exposure. We are applying quantitative mass spectrometry to explore differences in plasma protein abundance in 500 Nepalese children 6–8 yr of age born to mothers who were randomized (100 each) to receive daily supplements of folic acid (FA), iron+FA (IFA), IFA+zinc (IFAZ), multiple MNs, or placebo from 1st trimester to 6 wk postpartum. All tablets also contained vitamin A. Among ~980 plasma proteins measured in ≥ 10% of children, preliminary analysis reveals 9, 10, 8 and 14 proteins were differentially abundant in the FA, IFA, IFAZ and multiple MN vs. control group (all p< 0.01). So far, insulin‐like growth factor‐binding protein 5, ATP‐binding cassette sub‐family A, and eukaryotic translation initiation factor 3 are differentially abundant from controls in 2 nutrient groups. Insulin‐like growth factor 1 was highly abundant in FA, IFAZ, and multiple MNs compared to placebo. Early life micronutrient exposure may influence early childhood plasma protein profiles by presumably interacting with genes regulating growth and development. Supported by the Bill and Melinda Gates Foundation (Grants GH5241 and GH614).Grant Funding Source: Bill and Melinda Gates Foundation

Effects of Antenatal Micronutrient Supplementation on Cortisol and Erythropoietin in Pregnant Nepalese Women

Antenatal iron and multiple micronutrient supplementation improves birth weight. We examined whether this effect was mediated by reducing maternal stress and related factors that could compromise pregnancy outcomes. We examined late pregnancy serum erythropoietin (EPO) and cortisol in relation to maternal iron supplementation and iron status indicators (hemoglobin, Hb; ferritin, ferr; transferrin receptor, TfR) in 737 rural Nepalese women who participated in a 5-arm randomized, controlled micronutrient supplementation trial during pregnancy through 3 months postpartum. Women were randomized to receive vitamin A alone (as control), or with folic acid, folic acid+iron, folic acid+iron+zinc and a multiple micronutrient supplement (MN). EPO was ~0.5 mIu/ml lower (P<0.0001) in all groups receiving iron compared to the control group, with no difference in the folic acid only group. Cortisol was 1.3μg/dl lower (P=0.0422) in the MN group compared to the control group with no difference in other groups. Cortisol was associated with EPO (r = 0.20, P=0.008), TfR (r = 0.20, P=0.007), Ferr (−0.02, NS), and Hb (−0.15, p=0.053) in the control group. Hypoxia may elevate cortisol during iron deficiency. Reduction in mediators of maternal stress, including impaired erythropoeisis, is a likely mechanism by which iron and micronutrient supplementation may enhance birth weight. Support: USAID, Gates Foundation.

Physical activity and BMI in adolescence

receipt, with or without added iron orzinc.The two trials in southern Nepal sug-gest that neonatal mortality rose afterdaily use of an antenatal micronutrientsupplement that also increased birth-weight. Although chance couldexplain this effect, the statisticalstrength obtained from our pooledanalysis suggests that this is a lesslikely explanation than other sus-pected or unknown mechanisms, atleast in this rural south Asian setting.As we emphasised earlier, it ispresently inappropriate to extrapolatethese findings to other populations.However, our findings do support anemerging concept that antenatal sup-plements might need to be formu-lated to optimise benefit and minimiserisk on a broad, regional basis, takinginto consideration general profiles ofnutritional status, size, and diseaseburden. Assessment of the full public-health effect of antenatal micronutri-ent supplementation in malnourishedpopulations represents an urgentresearch priority.