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Background/objectiveLow birthweight (LBW) and intrauterine growth restriction are linked with maternal nutritional status during pregnancy, and maternal supplementation with multiple micronutrients (MMNs) is reported to increase birthweight. Responses to MMN, however, might be modified by maternal nutrition.Subjects/methodsTo examine the differential effects of maternal nutritional status on birthweight responses to prenatal MMN supplementation, data from the Supplementation with Multiple Micronutrient Intervention Trial, a cluster-randomized trial in Indonesia was analyzed. Birthweight outcomes of 7001 infants whose mothers received iron/folic acid were compared with 7292 infants whose mothers received MMN. The modifying effects of maternal short-term nutritional status (mid-upper arm circumference (MUAC) and long-term nutritional status (height) on the birthweight response to MMN supplementation were assessed.ResultsFor women with higher MUAC (≥23.5 cm), MMN increased mean birthweight by 33 g (95% confidence interval (CI): -1 to 66, P=0.06) and significantly reduced LBW by 21% (relative risk: 0.79, 95% CI: 0.64-0.99, P=0.04). The modifying effect of MUAC on mean birthweight, LBW and small for gestational age was significant. There was no evidence of a modifying effect of maternal height on the response to MMN.ConclusionsSupplementation with MMN in pregnancy increased birthweight, but maternal nutritional status modified this response, with infants born to women with better short-term nutrition having greater birthweight response.

Original publication

DOI

10.1038/ejcn.2011.97

Type

Journal

European journal of clinical nutrition

Publication Date

10/2011

Volume

65

Pages

1110 - 1117

Addresses

SUMMIT Institute of Development, Gedung Pusat Penelitian Bahasa dan Kebudayaan, University of Mataram, Mataram, Indonesia. sksebayang@yahoo.com

Keywords

Humans, Fetal Growth Retardation, Birth Weight, Iron, Dietary, Micronutrients, Cluster Analysis, Linear Models, Follow-Up Studies, Nutritional Status, Pregnancy, Socioeconomic Factors, Dietary Supplements, Adult, Infant, Infant, Newborn, Infant, Low Birth Weight, Indonesia, Female, Male, Maternal Nutritional Physiological Phenomena, Young Adult