Effect of balanced protein energy supplementation during pregnancy on birth outcomes

Imdad, Aamer; Bhutta, Zulfiqar Ahmed

doi:10.1186/1471-2458-11-s3-s17

Cited by 108 publications

(87 citation statements)

References 25 publications

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“…5 In 2011, an estimated 165 million children aged ,5 years worldwide had stunted growth, with the majority residing in Asia and sub-Saharan Africa. 6 Prenatal multiple micronutrient (MMN) 7 and balanced energy and protein 8 supplementation result in a significant reduction in small-for-gestational age births (9% and 31%, respectively). However, the results of such interventions on postnatal growth yielded more dispersed results.…”

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confidence: 99%

Prenatal Nutrient Supplementation and Postnatal Growth in a Developing Nation: An RCT

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Prenatal lipid-based nutrient supplementation has been demonstrated to increase birth length. However, the impact of this intervention on infant growth and morbidity is unknown. WHAT THIS STUDY ADDS:Infants from mothers who were given prenatal lipid-based nutrient supplements showed decelerated linear growth. The gain in length at birth related to prenatal lipidbased nutrient supplementation was not sustained during infancy. abstract BACKGROUND AND OBJECTIVES: Prenatal lipid-based nutrient supplements (LNS) have been shown to improve birth anthropometry. However, little is known about the effects of such supplements on infant health. We hypothesized that prenatal LNS compared with multiple micronutrient supplement for pregnant and lactating women would improve survival, growth, and morbidity during infancy. METHODS:Infants' weight, length, head, chest, and mid-upper arm circumferences were measured during monthly home visits from birth to 12 months of age in the Micronutriments et Santé de la Mère et de l'Enfant-2 trial. Differences in stunting and wasting episodes between study arms were assessed by Cox regression for recurrent event models. Morbidity signs during the 2 weeks before the visits and death cases were also assessed by multilevel analysis accounting for repeated individual measurements.RESULTS: Infant length-for-age growth (-0.033 z score/month; 95% confidence interval: -0.601 to -0.006; P = .018) for the LNS group was inferior to that of the control group. We did not find evidence of significant difference in mortality or morbidity between groups. CONCLUSIONS:The previously reported positive effect of prenatal LNS on birth length was not sustained during the postnatal phase. Prenatal LNS does not appear to make a long-lasting difference in child linear growth. Pediatrics 2014;133:e1001-e1008 Size at birth and growth in early infancy are important indicators of early childhood survival and health. Newborns with small birth size, reflecting poor intrauterine nutrition and/or prematurity, have an increased riskofinfant mortality and morbidity, 1 impaired child cognitive development, 2 and adverse health outcomes in adulthood. 3 Poor infant growth is associated with higher mortality and neurocognitive delays. 4,5 Stunted growth during the first 2 years is also associated with shorter adult height, reduced economic productivity, and decreased reproductive performance. 5 In 2011, an estimated 165 million children aged ,5 years worldwide had stunted growth, with the majority residing in Asia and sub-Saharan Africa. 6 Prenatal multiple micronutrient (MMN) 7 and balanced energy and protein 8 supplementation result in a significant reduction in small-for-gestational age births (9% and 31%, respectively). However, the results of such interventions on postnatal growth yielded more dispersed results. In 2 prenatal multiple MMN trials in Burkina Faso and Vietnam, the rate of stunting was reduced during infancy 9 and at 2 years, 10 although no difference was seen at 2.5 years in the ...

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confidence: 99%

Prenatal Nutrient Supplementation and Postnatal Growth in a Developing Nation: An RCT

et al. 2014

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“…Factors that have previously been found to contribute to intrauterine growth have included maternal nutrition (Belkacemi, Nelson, Desai, & Ross, 2010; Imdad & Bhutta, 2011) and placental development (Belkacemi et al, 2010), physical activity during pregnancy (Takito, Benicio, & Neri Lde, 2009), psychosocial stress (Littleton, Bye, Buck, & Amacker, 2010), and tobacco exposure (Suter, Abramovici, & Aagaard-Tillery, 2010), among others. Indeed, it appears that there may be complex relations between prenatal smoking exposure and the phenotypes of interest in the current investigation.…”

Section: Discussionmentioning

confidence: 99%

Does low birth weight share common genetic or environmental risk with childhood disruptive disorders?

Ficks¹,

Lahey

Waldman

2013

Journal of Abnormal Psychology

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Although advances in neonatal care over the past century have resulted in increased rates of survival among at-risk births, including infants with low birth weight, we have much to learn about the psychological outcomes in this population. In particular, although it appears that there is growing evidence that low birth weight may be associated with an increased risk for Attention-Deficit/Hyperactive Disorder (ADHD) symptoms in childhood, few studies have examined birth weight as a risk factor for disruptive disorders that commonly co-occur with ADHD [e.g. Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD)]. In addition, the etiology of the relation between birth weight and these disorders is unknown. The current investigation aimed to better understand the putative role of birth weight in disruptive behavior disorders in the context of potentially confounding genetic and environmental influences by examining phenotypic associations between birth weight and disruptive disorder symptoms across families (using generalized linear models with generalized estimating equations) as well as within families (using linear regression) in two independent twin samples (Sample 1: N = 1676 individuals; Sample 2: N = 4038 individuals). We found negative associations between birth weight and several childhood disruptive disorder symptom dimensions, including inattentive, hyperactive-impulsive, and broad externalizing symptoms in both samples. Nonetheless, the overall magnitude of these associations was very small, contributing to less than 1% of the variance in these symptom dimensions. Within-family associations between birth weight and disruptive disorder symptoms did not differ for monozygotic and dizygotic twin pairs, suggesting that nonshared environmental influences rather than common genetic influences are responsible for these associations. These consistent albeit weak associations between birth weight and disruptive disorder symptoms suggest that, at least in the general population, low birth weight does not represent a major risk factor in the development of these symptoms.

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“…Interventions that focused on multiple micronutrients along with balanced energy and protein during pregnancy have even greater results on SGA [14, 32, 34]. Other trials have shown reduction in LBW by 20% with daily consumption of iron supplements and increases in birthweight with calcium supplementation in pregnant women [34]. …”

Section: Linear Growth From Preconception To Beyond the First 1000 Dmentioning

confidence: 99%

World Perspective on the Epidemiology of Stunting between 1990 and 2015

2017

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Background: Stunting is the most prevalent form of child undernutrition with current worldwide estimates at 156 million. The majority of these children reside in low- and middle-income countries. When stunting prevails to adulthood, optimal growth potential and economic productivity are minimized. Results: In 2015 there were 98.5 million fewer stunted children under 5 years of age than in 1990. In East Asia and Pacific and South Asia, the stunting prevalence decreased by 24.8 and 25%, respectively. Minimal declines were observed in Latin America and the Caribbean at 12.6%, in the Middle East and North Africa at 12.9%, and in sub-Saharan Africa at 13.4%. But because large populations of children under 5 years of age are distributed disproportionately, decreases in prevalence do not translate to fewer numbers of stunted children globally. In sub-Saharan Africa, the number of stunted children increased by 12.4 million between 1990 and 2015. Conclusions: Adult height is dependent on nutrition-specific or nutrition-sensitive factors. Nutrition-specific factors can be targeted according to their impact at critical points of development and therefore offer multiple windows of opportunity for interventions. To date, many interventions focus on the first 1,000 days, but opportunities may extend into later childhood and adolescence.

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Effect of balanced protein energy supplementation during pregnancy on birth outcomes

Cited by 108 publications

References 25 publications

Prenatal Nutrient Supplementation and Postnatal Growth in a Developing Nation: An RCT

Prenatal Nutrient Supplementation and Postnatal Growth in a Developing Nation: An RCT

Does low birth weight share common genetic or environmental risk with childhood disruptive disorders?

World Perspective on the Epidemiology of Stunting between 1990 and 2015

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