Micronutrients Supplementation during Preconception Period Improves Fetal Survival and Cord Blood Insulin-Like Growth Factor 1

Abstract

The objective of this study was to evaluate the efficacy of multi-micronutrients (MMN) supplementation during preconception period on improving fetal survival and concentration of umbilical cord Insulin-like Growth Factor 1 (IGF-1). A randomized double blind community based trial had been conducted. Study subjects were randomly assigned into two groups (n = 210 in each group), namely multi-micronutrient group (MMN group) and placebo-iron folic acid group (Placebo-IFA group). The MMN group received capsule of multi-micronutrients containing 15 micronutrients every 2 days during preconception period (2-6 months before pregnancy) and to be continued with daily dose during pregnancy. Placebo-IFA group received placebo capsule every 2 days during preconception period (2-6 months before pregnancy) and to be continued with daily dose of iron and folic acid during pregnancy. Four hundred twenty eligible subjects were enrolled to meet approximately 115 babies born. The outcome variables were fetal survival and concentration of serum umbilical cord IGF-1. Data were analyzed using independent t-test to compare mean difference between MMN group and Placebo-IFA group and chi-square was used for dichotomous data to analyzed odd ratio. Results demonstrated significant difference of fetal survival (gestation age >37 weeks) between MMN group and Placebo-IFA group (p = 0.003). Fetuses in MMN group were more likely to survive than those in Placebo-IFA group (OR = 6,099; 95% CI: 0.934-39.847). ). These findings imply that MMN supplementation prior to pregnancy is very important to support intra uterine environment in early pregnancy for successful complete gestation period.

Preconception and periconception interventions to prevent low birth weight, small for gestational age and preterm birth: a systematic review and meta-analysis

“…Unique studies included 37 RCTs, 3 cluster RCTs and 18 quasi-experimental studies (table 1). 18 19 30–93…”

“…Twenty-eight studies examined nutritional interventions. Of these, 10 studies examined multiple micronutrient supplementation 18 35 41 45 50 53 56 63 64 66 76 85 87 89. Five studies, including one study which also had a multiple micronutrient supplementation arm, examined iron and folic acid supplementation 18 39 46 47 56 58 65.…”

“…Forty studies reported on at least one primary outcome 18 19 30 31 34 36–41 43 46 47 49 51 53–64 66–80 87–89 93. Eighteen studies assessed one or more secondary outcomes of interest 32 33 35 42 44 45 48 50 52 65 81–86 90–92.…”

Effect of preconception multiple micronutrients vs. iron–folic acid supplementation on maternal and birth outcomes among women from developing countries: a systematic review and meta-analysis

“…However, recent systematic reviews have found the beneficial roles of multiple micronutrients (MMNs) over IFA when supplemented during pregnancy (8,9). There have been published clinical trials that have investigated the efficacy of different MMN supplements during preconception on birth outcomes, and the results have been variable (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). The World Health Organization (WHO) in 2016 "did not recommend" MMN supplementation during pregnancy; however, in 2020, this was revised to "recommended in the context of rigorous research" (22).…”

The Body Size and Micronutrients Status Among the Bride-To Be in Probolinggo Districtof East Java

“…Iron status and several micronutrients status also affected a pregnancy and its outcomes. Both animal studies and human observational studies evidenced that micronutrients deficiency in pre-pregnancy or during pregnancy was associated with a poor pregnancy or neonate (Ronnenberg, 2004;Bodnar, 2006;Catove, 2007;Beard, 2007;Sri Sumarmi, 2015). The low quality of the newborn baby was probably caused by not a single micronutrient deficiency, but by multiple micronutrients deficiency (Sunawang, 2009;Bhutta, 2009;Cetin, 2010;Kawai, 2011;Black, 2013).…”