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This Article Full Text (Publish Ahead of Print[PDF]) All Versions of this Article: 90/6/1593    most recent ajcn.2009.28253v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Huybregts, L. Articles by Kolsteren, P. PubMed PubMed Citation Articles by Huybregts, L. Articles by Kolsteren, P. Agricola Articles by Huybregts, L. Articles by Kolsteren, P.

Prenatal food supplementation fortified with multiple micronutrients increases birth length: a randomized controlled trial in rural Burkina Faso^1,2,3,4

¹ From the Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium (LH, HL, JVC, and PK); the Child Health and Nutrition Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium (DR, JM, and PK); the Centre Muraz, Ministry of Health, Bobo-Dioulasso, Burkina Faso (NM); and IRSS, Ouagadougou, Burkina Faso (HL).

² None of the sponsors had any role in the study design, data collection, data analysis, or writing of the report.

³ Supported by Flemish University Council, Nutrition Third World, and the Belgian Ministry of Development. The multiple micronutrient premix was donated by Nutriset, France.

⁴ Address correspondence to P Kolsteren, Child Health and Nutrition Unit, Department of Public Health, Institute of Tropical Medicine, 155, Nationalestraat, 2000 Antwerp, Belgium. E-mail: pkolsteren{at}itg.be.

for the MISAME Study Group

ABSTRACT

Background: Prenatal multiple micronutrient (MMN) or balanced energy and protein supplementation has a limited effect on birth size of the offspring.

Objective: The objective was to determine whether a prenatal MMN-fortified food supplement (FFS) improves anthropometric measures at birth compared with supplementation with an MMN pill alone.

Design: We conducted a nonblinded, individually randomized controlled trial in 1296 pregnant women in 2 villages in rural Burkina Faso. Supplements were provided on a daily basis, and compliance was closely verified by using a community-based network of home visitors.

Results: Anthropometric measures at birth were available for analysis for 87% of the 1175 live singleton deliveries enrolled. After adjustment for gestational age at birth, the FFS group had a significantly higher birth length (+4.6 mm; P = 0.001). FFS supplementation resulted in a modestly higher birth weight (+31 g; P = 0.197). Subgroup analyses showed clinically important treatment effects on birth length (+12.0 mm; P = 0.005) and on birth weight (+111 g; P = 0.133) for underweight [body mass index (in kg/m²) <18.5] pregnant women. Women with early pregnancy anemia who received FFS gave birth to taller newborns (+7.3 mm; P = 0.002) than did those who received MMN supplementation.

Conclusions: The provision of FFS to pregnant women resulted in higher birth length than did MMN supplementation. For women with a suboptimal prepregnancy nutritional status, MMN supplementation should be complemented with a balanced energy and protein supplement to produce a clinical effect on birth size. The trial was registered at clinicaltrials.gov as NCT00909974.

Received for publication June 17, 2009. Accepted for publication September 1, 2009.