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Association of a prenatal lipid-based nutritional supplement with fetal growth in rural Gambia

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posted on 04.08.2016 by Will Johnson, M.K. Darboe, Fatou Sosseh, P. Nshe, A.M. Prentice, Sophie E. Moore
Prenatal supplementation with protein-energy (PE) and/or multiple-micronutrients (MMN) may improve fetal growth, but trials of lipid-based nutritional supplements (LNS) have reported inconsistent results. We conducted a post-hoc analysis of non-primary outcomes in a trial in Gambia, with the aim to test the associations of LNS with fetal growth and explore how efficacy varies depending on nutritional status. The sample comprised 620 pregnant women in an individually randomized, partially blinded trial with four arms: 1) iron and folic acid (FeFol) tablet (usual care, referent group), 2) MMN tablet, 3) PE LNS, and 4) PE + MMN LNS. Analysis of variance examined unadjusted differences in fetal biometry Z-scores at 20 and 30 weeks and neonatal anthropometry Z-scores, while regression tested for modification of intervention-outcome associations by season and maternal height, BMI, and weight gain. Despite evidence of between-arm differences in some fetal biometry, Z-scores at birth were not greater in the intervention arms than the FeFol arm (e.g., birth weight Z-scores: FeFol -0.71, MMN -0.63, PE -0.64, PE + MMN -0.62; group-wise p = 0.796). In regression analyses, intervention associations with birth weight and head circumference were modified by maternal weight gain between booking and 30 weeks gestation (e.g., PE + MMN associations with birth weight were + 0.462 Z-scores (95% CI 0.097, 0.826) in the highest quartile of weight gain but - 0.099 Z-scores (-0.459, 0.260) in the lowest). In conclusion, we found no strong evidence that a prenatal LNS intervention was associated with better fetal growth in the whole sample.

History

School

  • Sport, Exercise and Health Sciences

Published in

Maternal and Child Nutrition

Citation

JOHNSON, W.O. ...et al., 2016. Association of a prenatal lipid-based nutritional supplement with fetal growth in rural Gambia. Maternal and Child Nutrition, 13 (2), e12367.

Publisher

Wiley © The Authors

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/

Acceptance date

20/07/2016

Publication date

2016-10-02

Copyright date

2017

Notes

This is an Open Access Article. It is published by Wiley under the Creative Commons Attribution 4.0 International Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/

ISSN

1740-8709

Language

en

Licence

Exports