News Release

Children born to mothers given multiple micronutrient supplementation are bigger and heavier

Peer-Reviewed Publication

The Lancet_DELETED

Children born to mothers given multiple micronutrient supplementation (MMN) are bigger and heavier than those born to mothers given iron and folic acid supplementation alone (IFA), an effect that extends into the first three years of the children’s lives. This is the conclusion of authors of an Article in this week’s edition of The Lancet, which follows up the recent Lancet Series on Maternal and Child Undernutrition.

Although we know that low birthweight affects child morbidity and survival in developing countries, it is less clear what effect interventions to raise birthweight might have on child health.

Dr David Osrin, UCL Centre for International Health and Development, Institute of Child Health, London, UK and colleagues from Mother and Infant Research Activities, Kathmandu, Nepal, had previously published findings from a randomised controlled trial in Nepal in which 1200 women received either IFA, or a supplement that provided the recommended daily allowance of 15 vitamins and minerals (MMN), over the second and third trimesters of pregnancy. That study showed that birthweight of children born to mothers given MMN were on average 77g heavier than those born to mothers given IFA.

The new findings come from follow-up of 917 of these children now they are older - an average age of 2.5 years - 455 in the IFA (control) group, and 462 in the MMN group. It was found that the children of MMN mothers weighed 10.9kg, and those of IFA mothers 10.7kg – with a mean difference of 204g between children in the two groups. The children of MMN mothers were also bigger than those of IFA mothers – with head circumference a mean of 2.4mm bigger, chest circumference a mean 3.2mm bigger, mid-upper arm circumference a mean 2.4mm bigger, and triceps skinfold thickness a mean 2.0mm bigger. Finally, systolic blood pressure was also a mean of 2.5 mm Hg lower in the children born to MMN mothers.

The authors conclude: “In a poor population, the effects of maternal multiple micronutrient supplementation on the fetus persisted into childhood, with increases in both weight and body size. These increases were small, however, since those exposed to micronutrients had an average of 2% higher weight than controls. The public-health implications of changes in weight and blood pressure need to be clarified through follow-up.”

In an accompanying Comment, Dr Keith West and Dr Parul Christian, Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, say: “At present, the clearest lesson from the study by Osrin and colleagues lies in the example it sets for successful follow-up of randomised trial cohorts of children that can reveal latent causal effects of antenatal micronutrient supplementation on growth and chronic-disease risk in undernourished populations.”

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Dr David Osrin, UCL Centre for International Health and Development, Institute of Child Health, London, UK T) +44 (0) 20 7905 2261 E) d.osrin@ich.ucl.ac.uk

Dr Keith West and Dr Parul Christian, Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. T) +1 410-955-2061 E) kwest@jhsph.edu / pchristi@jhsph.edu

PDF OF THE ARTICLE: http://multimedia.thelancet.com/pdf/press/Nepal.pdf


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