Impact of Preconception Micronutrient Supplementation on Anemia and Iron Status during Pregnancy and Postpartum: A Randomized Controlled Trial in Rural Vietnam

Nguyen, Phuong Hong; Young, Melissa; González-Casanova, Inés; Pham, Hoa; Nguyen, Hieu; Truong, Truong V; Nguyen, Son; Harding, Kimberly; Reinhart, Gregory A.; Martorell, Reynaldo; Ramakrishnan, Usha

doi:10.1371/journal.pone.0167416

Cited by 41 publications

(54 citation statements)

References 42 publications

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“…In the case of iron and zinc, supplementation increased the intake above the recommended level. In the studies of de Sá et al and Nguyen et al, which considered iron supplementation during pregnancy, similar results were found [ 34 , 35 ]. These authors, however, noted that despite the increase in the intake of iron by supplementation, the hoped-for reduction in the occurrence of anaemia among women was not achieved.…”

Section: Discussionsupporting

confidence: 69%

Assessment of dietary intake and mineral status in pregnant women

Kocyłowski

Lewicka

Grzesiak

et al. 2018

Arch Gynecol Obstet

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PurposeTo evaluate the dietary intake of pregnant women and their nutritional status of Ca, Mg, Fe, Zn, and Cu, as the nutritional status of pregnant women is an important factor for the proper progression of a pregnancy and the development and health of the foetus.MethodsThe study was conducted on 108 pregnant women ages 18–42, at 6–32 weeks of gestation. We used a questionnaire and a 24-h recall nutrition interview. Hair samples were taken for testing and the level of each mineral was assessed using atomic absorption spectrometry. The results were analysed using the Dietetyk and Statistica 10 software.ResultsLow levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid intake were seen in the pregnant women, with the use of dietary supplements significantly increasing their intake of Fe, Zn, and folic acid. The concentration of zinc and magnesium in the women’s hair was shown to be affected by their age and, in the case of magnesium, by the week of pregnancy.ConclusionsIt was observed that the diet of pregnant women is characterised by low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid. Dietary supplementation with vitamins and minerals significantly increases the daily Fe and folic acid intake in pregnant women. The concentration of Zn and Mg in hair depends on the age of pregnant women and Mg level in the hair of women decreases during pregnancy.

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Section: Discussionsupporting

confidence: 69%

Assessment of dietary intake and mineral status in pregnant women

Kocyłowski

Lewicka

Grzesiak

et al. 2018

Arch Gynecol Obstet

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“…<11 gm/dl), while 14 women had SFC<15 ng/ml, for a frequency of anemia, ID and IDA of 19.3%, 15.9% and 11.4%. These figures coincided with that previously reported by Sukrat et al (2) and Siridamrongvattana et al (3) and with the recently reported by Nguyen et al (25) who found 20% of pregnant women were anemic, 14% had low iron stores and 3% had IDA and by Okafor et al (26) who detected ID and IDA in 20% and 17.9% of pregnant women.…”

Section: Discussion:-supporting

confidence: 92%

Gestational Iron Deficiency Anemia Is Not Simply a Consequence of Iron Deficiency: An Observational Study for Cofounders.

HeshamMAboRagab¹,

EhabBarakat²,

OmmniaAbdulla³

2018

IJAR

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Objectives:To evaluate serum levels of vitamin D (VD), hepcidin, interleukin (IL)-6 and iron indices in pregnant women Patients & Methods: 88 pregnant women fulfilling the inclusion criteria underwent full clinical examination and gave blood samples for determination of hemoglobin concentration (Hb. Conc.), and ELISA estimation of serum 25-hydroxy VD (25OH-VD), ferritin concentration (SFC), hepcidin and IL-6 at the 6 th wk gestational age (Booking time) and underwent re-determination of Hb. Conc. at start of the 3 rd trimester and Hb. Deficit was calculated. Study outcome included determination of the frequency of iron deficiency (ID), iron deficiency anemia (IDA) and VD deficiency (VDD) and evaluation of the relations between these parameters. Results: At booking time, 17 women were anemic (Hb. Conc. <11 gm/dl), while 14 women had SFC<15 ng/ml, for a frequency of anemia, ID and IDA of 19.3%, 15.9% and 11.4%, respectively. At the 3 rd trimester, 35 women had Hb. Conc. <11 gm/dl, thus the frequency of IDA was doubled during pregnancy with significantly (p=0.0029) higher frequency of anemic women and significantly (p=0.0007) lower mean Hb. Conc. compared to booking time with a median decrease of Hb. deficit by 4.96% (95% ICR: -7 to -3.23). At booking time, 17 women had insufficient VD levels and 64 women had VDD. At booking Hb. Conc. and deficit was significantly correlated with serum FC, 25OH-VD, hepcidin and IL-6. Serum 25OH-VD level showed significant correlation with SFC, hepcidin and IL-6 levels, and serum hepcidin levels was significantly correlated with serum FC and IL-6. Regression analysis defined at booking high serum hepcidin and IL-6 as significant negative, while high serum 25OH-VD level as significant positive predictor for oncoming 3 rd trimester Hb. conc. For prediction of the extent of Hb. deficit, at booking high serum 25OH-VD was negative (β=-0.307, p=0.004), while serum IL-6 level was positive (β=0.235, p=0.026) significant predictors for high deficit. Conclusion: Gestational IDA is a progressive condition weakly responding to iron supplemental therapy. IDA is a multi-factorial condition strongly associated with VDD, disturbed immune milieu and deregulated iron homeostasis. VDD plays a crucial role in pathogenesis of ADI.

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“…Women were then followed up prospectively to identify pregnancies ( n = 1,813) and evaluate birth outcomes ( n = 1,579). Results from the original trial show that weekly supplementation with MM or IFA before conception did not affect birth outcomes compared with FA (Ramakrishnan et al, ), but resulted in modest increases in maternal and infant iron stores (Nguyen, Young, et al, ) and improved maternal mental health among women at risk for depression (Ramakrishnan et al, ). In the second phase, all live singleton births were followed up for growth at 1 year and child development at 2 years of age ( n = 1,458), the sample used in the current analyses.…”

Section: Methodsmentioning

confidence: 99%

Influences of early child nutritional status and home learning environment on child development in Vietnam

Nguyen

DiGirolamo

González-Casanova

et al. 2017

Maternal & Child Nutrition

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Early childhood development plays a key role in a child's future health, educational success, and economic status. However, suboptimal early development remains a global challenge. This study examines the influences of quality of the home learning environment (HOME) and child stunting in the first year of life on child development. We used data collected from a randomized controlled trial of preconceptional micronutrient supplementation in Vietnam (n = 1,458). The Bayley Scales of Infant Development-III were used to assess cognition, language, and motor development domains at 2 years. At 1 year, 14% of children were stunted, and 15%, 58%, and 28% of children lived in poor, medium, and high HOME environments, respectively. In multivariate generalized linear regression models, living in a high HOME environment was significantly associated with higher scores (0.10 to 0.13 SD) in each of the developmental domains. Stunted children scored significantly lower for cognitive, language, and motor development (−0.11 to −0.18), compared to nonstunted children. The negative associations between stunting on development were modified by HOME; the associations were strong among children living in homes with a poor learning environment whereas they were nonsignificant for those living in high-quality learning environments. In conclusion, child stunting the first year of life was negatively associated with child development at 2 years among children in Vietnam, but a high-quality HOME appeared to attenuate these associations. Early interventions aimed at improving early child growth as well as providing a stimulating home environment are critical to ensure optimal child development.

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Impact of Preconception Micronutrient Supplementation on Anemia and Iron Status during Pregnancy and Postpartum: A Randomized Controlled Trial in Rural Vietnam

Cited by 41 publications

References 42 publications

Assessment of dietary intake and mineral status in pregnant women

Assessment of dietary intake and mineral status in pregnant women

Gestational Iron Deficiency Anemia Is Not Simply a Consequence of Iron Deficiency: An Observational Study for Cofounders.

Influences of early child nutritional status and home learning environment on child development in Vietnam

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