Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women

Abstract

Objective: To test the hypothesis that maternal food fortification with omega-3 fatty acids and multiple micronutrients increases birth weight and gestation duration, as primary outcomes. Design: Non-blinded, randomised controlled study. Setting: Pregnant women received powdered milk during their health check-ups at 19 antenatal clinics and delivered at two maternity hospitals in Santiago, Chile. Subject: Pregnant women were assigned to receive regular powdered milk (n 5 477) or a milk product fortified with multiple micronutrients and omega-3 fatty acids (n 5 495). Results: Intention-to-treat analysis showed that mean birth weight was higher in the intervention group than in controls (65.4 g difference, 95% confidence interval (CI) 5-126 g; P 5 0.03) and the incidence of very preterm birth (,34 weeks) was lower (0.4% vs. 2.1%; P 5 0.03). On-treatment analysis showed a mean birth weight difference of 118 g (95% CI 47-190 g; P 5 0.001) and a relative fall in both the proportion of birth weight #3000 g (P 5 0.015) and the incidence of preeclampsia (P 5 0.015). Compliance with the experimental product was apparent from a haematological study of red-blood-cell folate at the end of pregnancy, which was performed in a sub-sample. In both types of analyses, positive differences were also present for mean gestation duration, birth length and head circumference. Nevertheless, the relatively small sample sizes allowed a statistical power of .0.80 just for mean birth weight and birth length in the on-treatment analysis; birth length in that analysis had a difference of 0.57 cm (95% CI 0.19-0.96 cm; P 5 0.003). Conclusions:The new intervention resulted in increased mean birth weight. Associations with gestation duration and most secondary outcomes need a larger sample size for confirmation.

Nutritional Disparities among Women in Urban India

“…different types of green beans) which continue to be the largest source of iron; (d) experiment with strategies to improve compliance to consumption of iron folic acid tablets; (e) test alternative models to reduce iron-deficiency anaemia in such settings. In other developing countries, the use of energy-dense micronutrients-ready-to-use food supplements-has proven successful in the prevention of anaemia and improving birth outcomes (17)(18); (f) measures to prevent helminthic infestations would also require to be strengthened, more so in slum settings where many women work or walk barefoot (and hence at a risk of hookworm infestation); and (g) contamination of water is also high, increasing the risk of intestinal worm infestation and calling for expeditious efforts to improve access of the urban poor and deprived populations to safe drinking-water. The risk of hookworm and intestinal worms makes it imperative that national deworming guidelines for pregnant women be established explicitly, mentioning the dosage and frequency of deworming tablets.…”

Associations of Prenatal Growth with Metabolic Syndrome, Insulin Resistance, and Nutritional Status in Chilean Children

“…They were determined at the maternity hospitals immediately after delivery by trained personnel [17, 18]. Infants were weighed using a 1583 Tanita electronic scale (Tanita Corporation, Arlington Heights, IL) with an accuracy of 10 g or an electronic scale, Seca 345, the accuracy being 20 g (Secacorp, Hamburg, Germany).…”

Influencia combinada del índice de masa corporal pregestacional y de la ganancia de peso en el embarazo sobre el crecimiento fetal

“…En cuanto a los promedios de datos del parto y del recién nacido que provee el sistema de salud chileno y que fueron utilizados en este estudio, se puede decir que son considerados de cobertura prácticamente completa de la población y altamente confi ables, según lo indicado en varias publicaciones realizadas en los últimos años dentro y fuera del país 7,8,[14][15][16][17][18] .…”