Preconception nutrition intervention improved birth length and reduced stunting and wasting in newborns in South Asia: The Women First Randomized Controlled Trial

Abstract

South Asia has >50% of the global burden of low birth weight (LBW). The objective was to determine the extent to which maternal nutrition interventions commenced before conception or in the 1 st trimester improved fetal growth in this region. This was a secondary analysis of combined newborn anthropometric data for the South Asian sites (India and Pakistan) in the Women First Preconception Maternal Nutrition Trial. Participants were 972 newborn of mothers who were poor, rural, unselected on basis of nutritional status, and had been randomized to receive a daily lipid-based micronutrient supplement commencing �3 months prior to conception (Arm 1), in the 1 st trimester (Arm 2), or not at all (Arm 3). An additional protein-energy supplement was provided if BMI <20 kg/m 2 or gestational weight gain was less than guidelines. Gestational age was established in the 1 st trimester and newborn anthropometry obtained <48-hours post-delivery. Mean differences at birth between Arm 1 vs. 3 were length +5.3mm and weight +89g. Effect sizes (ES) and relative risks (RR) with 95% CI for Arm 1 vs.

Childbearing Age Women Characteristics in Latin America. Building Evidence Bases for Early Prevention. Results from the ELANS Study

“…In this study, more than 50% of women of childbearing age had a low socioeconomic status, meaning they were living in poverty, which challenges well-being, as demonstrated, for example, in studies on women of rural communities in south Asian countries [ 4 ]. Living in poverty increases the risk for food insecurity and consuming cheap foods with a low density of essential nutrients promotes micronutrient deficiencies (or hidden hunger) [ 34 , 35 ].…”

“…Maternal nutritional status at the time of oocyte implantation is a key determinant factor of embryonic and fetal growth [ 1 , 2 ]. Previous studies indicated that nutritional interventions prior to and during pregnancy can positively influence a newborn’s birthweight and well-being [ 3 , 4 , 5 ], making early dietary and lifestyle interventions a key strategy for achieving optimal population health. Obese women and their future children also benefit from interventions to achieve optimal weight before pregnancy, since obese childbearing-age women might have impaired fertility and increased risk for excessive weight gain during pregnancy, maternal complications, Cesarean delivery and fetal macrosomia, and ultimately higher mortality [ 6 , 7 ].…”

Effect of a Nutrient-Rich, Food-Based Supplement Given to Rural Vietnamese Mothers Prior to or during Pregnancy on the Trajectories of Nutrient Biomarkers

“…However, only two groups evaluated the impact of preconception supplementation in low-resource populations [ 33 , 34 ]. In the Women First Trial [ 34 , 35 ], a multicountry study done in the DR Congo, Guatemala, India, and Pakistan, fetal growth outcomes were improved if the supplement was provided before conception or late in the first trimester; the effect on maternal nutritional status has not been reported. In another Vietnam study, either a weekly multiple micronutrient supplement or a weekly iron/folate supplement were given to the women for at least 3 months prior to conception [ 33 ].…”

The effect of nutrition and reproductive health education intervention on pregnant women in reducing stunting in Indonesia: A-quasi experimental study

“…Reducing stunting is part of the Sustainable Development Goals (SDGs) [1]. In many countries, interventions to reduce stunting have been carried out since the pregnancy period [2,3]. Poor maternal reproductive health and nutrition during pregnancy has lifelong impacts on the health of the offspring [4].…”