Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial

Christian, Parul

doi:10.1136/bmj.326.7389.571

Cited by 331 publications

(394 citation statements)

References 17 publications

(19 reference statements)

Supporting

Mentioning

363

Contrasting

Unclassified

Order By: Relevance

“…However, under conditions of chronic undernutrition, supplementation of energy, proteins as well as micronutrients to the level of recommended dietary allowance during pregnancy resulted in only marginal improvements in birth weight (Christian et al, 2003;Kramer and Kakuma, 2003). The limited efficacy of these supplements may be owing to the inability of the body to lay down lean mass during pregnancy, because pregnancy is too short a window to increase lean mass.…”

Section: Discussionmentioning

confidence: 99%

Maternal lean body mass may be the major determinant of birth weight: a study from India

2006

View full text Add to dashboard Cite

This study explored the relationship of maternal body composition parameters to the birth weight of the offspring. Maternal anthropometric parameters (weight, height) and body composition by dual energy X-ray absorptiometry were measured in 76 women from low-income group during 12-21 days postpartum. The mean7s.d. height, weight of the mothers and birth weight of the newborns were 151.575.29 cm, 46.776.04 and 2.8470.358 kg, respectively. When the relationship of maternal anthropometric and body composition parameters to the infants' birth weight was studied, maternal lean body mass was found to be the most important determinant of birth weight (R 2 (%) ¼ 21.3) (Po0.001). This study highlights the importance of increasing lean body mass in young women for better pregnancy outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Maternal lean body mass may be the major determinant of birth weight: a study from India

2006

View full text Add to dashboard Cite

show abstract

“…13 The present study was conducted in a rural south eastern region of Nepal as part of a trial examining the effects of multiple micronutrients on low birth weight. 14 In a substudy we tested women at 6 weeks post partum for N gonorrhoeae and C trachomatis using the urine based ligase chain reaction (LCR) method. We describe the prevalence and risk factors for gonococcal and chlamydial infection in this population and examine the risk of low birth weight, preterm delivery, and neonatal eye discharge among infected women.…”

mentioning

confidence: 99%

Prevalence and risk factors of chlamydia and gonorrhea among rural Nepali women

Christian

Khatry

LeClerq

et al. 2005

Sexually Transmitted Infections

View full text Add to dashboard Cite

Objectives: The epidemiology of sexually transmitted infections (STI) in rural, developing world populations is poorly understood. We estimated the prevalence and risk factors of Neisseria gonorrhoeae and Chlamydia trachomatis in a female population in rural Nepal. Methods: We conducted a cross sectional study in a sample of 1177 postpartum women participating in a micronutrient supplementation trial in Nepal. Urine samples were collected to test for the two infections using the ligase chain reaction (LCR). Results: C trachomatis was detected in 1.0% (95% confidence intervals (CI): 0.4 to 1.5) and N gonorrhoeae in 2.3% (95% CI: 1.2 to 3.4) of women. None of the women tested positive for both. Self report of all three symptoms of lower abdominal pain, pain and burning on urination, and vaginal discharge was associated with the presence of gonorrhoea (odds ratio (OR): 12.1, 95% CI: 1.3 to 115.0). Neonatal eye discharge was associated with maternal gonococcal infection (OR = 5.2, 95% CI: 1.1 to 24.9). Incidence of low birth weight was not related to these maternal infections, but very preterm delivery (,32 weeks) was higher among women positive for gonorrhoea (OR = 4.7, 95% CI: 1.0 to 22.0). In a multivariable analysis, low body mass index (,18.5) and cattle ownership were associated with gonorrhoea (p ,0.05), whereas woman's literacy was associated with chlamydia (p = 0.06). Conclusion: We found the rates of N gonorrhoeae and C trachomatis to be low among women in this rural population of Nepal.

show abstract

“…This is supported by two recent studies in which prenatal multimicronutrient supplementation with one RDA did not increase bw (Christian et al, 2003;Ramakrishnan et al, 2003). In Mexico, 873 women were given either 60 mg of iron or a multimicronutrient supplement including iron 6 days a week from before 13 weeks of gestation until delivery (Ramakrishnan et al, 2003).…”

Section: Discussionmentioning

confidence: 65%

“…Bw measured o72 h after birth did not differ between supplementation groups. In Nepal, prenatal multimicronutrient supplementation did not add any additional effect over iron-folic acid in reducing the risk of low bw (Christian et al, 2003). Another recent study conducted in a population with 30% prevalence of HIV-1 in Zimbabwe suggested no effect in HIV-negative women of daily supplementation with one RDA of multimicronutrients (Friis et al, 2004).…”

Section: Discussionmentioning

confidence: 88%

“…Still, the evidence for benefits of multimicronutrient supplementation on pregnancy outcome is sparse (Ramakrishnan et al, 1999;Mahomed, 2000;Osrin & de Costello, 2000;Scholl & Reilly, 2000;Allen & Gillespie, 2001). Recent controlled trials in Mexico (Ramakrishnan et al, 2003) and Nepal (Christian et al, 2003) did not find any effects on bw of prenatal multimicronutrient supplementation in addition to the effect of iron and folic acid. However, doses of one recommended dietary allowance (RDA) may not be sufficient for pregnant women in populations with poor dietary quality and higher nutrient requirements and losses due to frequent infections.…”

Section: Introductionmentioning

confidence: 90%

See 1 more Smart Citation

Effects of prenatal multimicronutrient supplements on birth weight and perinatal mortality: a randomised, controlled trial in Guinea-Bissau

et al. 2005

View full text Add to dashboard Cite

Objectives: To assess the effects of daily prenatal multimicronutrient supplementation on birth weight (BW) and perinatal mortality. Design: Randomised, controlled, double masked trial. Setting: Urban Guinea-Bissau, West Africa. Subjects: A total of 2100 pregnant women (2277 weeks pregnant at entry) were recruited through antenatal clinics, of which 1670 (79.5%) completed the trial. BW was available for 1100 live born babies. Interventions: Identical-looking supplements containing one (MN-1) or two (MN-2) Recommended Dietary Allowances (RDA) of 15 micronutrients, or iron and folic acid (control). Results: Mean BW among 1100 live born infants was 30507498 g with 11.9% being low birth weight (LBW, BWo2500 g). Perinatal mortality was 82 per 1000 deliveries (N ¼ 1670), and neonatal mortality 45 per 1000 live births (N ¼ 1599). Mean BW in MN-1 (n ¼ 360) and MN-2 (n ¼ 374) groups were 53 [À19; 125] and 95 [24; 166] g higher than controls (n ¼ 366). Proportion of LBW was 13.6% in control, and 12.0 and 10.1% in the MN-1 and MN-2 groups, respectively (P ¼ 0.33). Among anaemic women (30%), MN-2 increased BW with 218 [81; 354] g compared to controls, with a decreased risk of LBW of 69 [27; 87]%. There were apparently no differences in perinatal mortality between groups. Conclusions: Prenatal micronutrient supplementation increased BW but did not reduce perinatal mortality in this study. Multimicronutrient supplementation with two RDA should be considered in future programmes to reduce the proportion of LBW.

show abstract

Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial

Abstract: Objective To assess the impact on birth size and risk of low birth weight of alternative combinations of micronutrients given to pregnant women. Design Double blind cluster randomised controlled trial.

Cited by 331 publications

References 17 publications

Maternal lean body mass may be the major determinant of birth weight: a study from India

Maternal lean body mass may be the major determinant of birth weight: a study from India

Prevalence and risk factors of chlamydia and gonorrhea among rural Nepali women

Effects of prenatal multimicronutrient supplements on birth weight and perinatal mortality: a randomised, controlled trial in Guinea-Bissau

Contact Info

Product

Resources

About