TY - JOUR
T1 - Growth from Birth Through Six Months for Infants of Mothers in the “Women First” Preconception Maternal Nutrition Trial
AU - the Women First Preconception Maternal Nutrition Study Group
AU - Krebs, Nancy F.
AU - Hambidge, K. Michael
AU - Westcott, Jamie L.
AU - Garcés, Ana L.
AU - Figueroa, Lester
AU - Tsefu, Antoinette K.
AU - Lokangaka, Adrien L.
AU - Goudar, Shivaprasad S.
AU - Dhaded, Sangappa M.
AU - Saleem, Sarah
AU - Ali, Sumera Aziz
AU - Bose, Carl L.
AU - Derman, Richard J.
AU - Goldenberg, Robert L.
AU - Thorsten, Vanessa R.
AU - Sridhar, Amaanti
AU - Chowdhury, Dhuly
AU - Das, Abhik
AU - Gado, Justin
AU - Somannavar, Manjunath S.
AU - Herekar, Veena
AU - Pasha, Omrana
AU - Khan, Umber
AU - McClure, Elizabeth M.
AU - Koso-Thomas, Marion
N1 - Funding Information:
Supported by the Bill & Melinda Gates Foundation , Seattle, WA (OPP1055867 [to K.H. and N.K.]), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of Dietary Supplements ( U10 HD 076474 [to N.K. and K.H.] and UG1 HD 076474 [to N.K.]). The authors declare no conflicts of interest.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Objective: To evaluate whether the fetal linear growth effects of maternal nutrition supplementation would be maintained through 6 months postnatal age. Study design: The Women First trial was a multicountry, individually randomized clinical trial that compared the impact of maternal nutrition supplementation initiated preconception (Arm 1) vs at ∼11 weeks of gestation (Arm 2), vs no supplement (Arm 3); the intervention was discontinued at delivery. Trial sites were in Democratic Republic of Congo, Guatemala, India, and Pakistan. Analysis includes 2421 infants born to 2408 randomized women. Primary outcome was the trajectory of length-for-age z scores (LAZ) by arm, based on assessments at birth and 1, 3, and 6 months. We fitted longitudinal models on growth from birth to 6 months using generalized estimating equations; maternal intervention effects were evaluated, adjusting for site and baseline maternal covariates. Results: Linear growth for Arms 1 and 2 was statistically greater than for Arm 3 in 3 of the 4 countries, with average pairwise mean differences in LAZ of 0.25 (95% CI 0.15-0.35; P <.001) and 0.19 (95% CI 0.09-0.28; P <.001), respectively. Compared with Arm 3, average overall adjusted relative risks (95% CI) for stunting (LAZ <–2) were lower for Arms 1 and 2: 0.76 (0.66-0.87; P <.001) and 0.77 (0.67-0.88; P <.001), respectively. Conclusions: Improved linear growth in early infancy observed for the 2 intervention arms supports the critical importance of maternal nutrition before conception and in the early phase of gestation. Trial Registration: ClinicalTrials.gov: NCT01883193.
AB - Objective: To evaluate whether the fetal linear growth effects of maternal nutrition supplementation would be maintained through 6 months postnatal age. Study design: The Women First trial was a multicountry, individually randomized clinical trial that compared the impact of maternal nutrition supplementation initiated preconception (Arm 1) vs at ∼11 weeks of gestation (Arm 2), vs no supplement (Arm 3); the intervention was discontinued at delivery. Trial sites were in Democratic Republic of Congo, Guatemala, India, and Pakistan. Analysis includes 2421 infants born to 2408 randomized women. Primary outcome was the trajectory of length-for-age z scores (LAZ) by arm, based on assessments at birth and 1, 3, and 6 months. We fitted longitudinal models on growth from birth to 6 months using generalized estimating equations; maternal intervention effects were evaluated, adjusting for site and baseline maternal covariates. Results: Linear growth for Arms 1 and 2 was statistically greater than for Arm 3 in 3 of the 4 countries, with average pairwise mean differences in LAZ of 0.25 (95% CI 0.15-0.35; P <.001) and 0.19 (95% CI 0.09-0.28; P <.001), respectively. Compared with Arm 3, average overall adjusted relative risks (95% CI) for stunting (LAZ <–2) were lower for Arms 1 and 2: 0.76 (0.66-0.87; P <.001) and 0.77 (0.67-0.88; P <.001), respectively. Conclusions: Improved linear growth in early infancy observed for the 2 intervention arms supports the critical importance of maternal nutrition before conception and in the early phase of gestation. Trial Registration: ClinicalTrials.gov: NCT01883193.
KW - breastfeeding
KW - infant growth
KW - postnatal growth
KW - small quantity-lipid nutrient supplement (SQ-LNS)
KW - stunting
UR - http://www.scopus.com/inward/record.url?scp=85096368327&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2020.09.032
DO - 10.1016/j.jpeds.2020.09.032
M3 - Article
C2 - 32956698
AN - SCOPUS:85096368327
SN - 0022-3476
VL - 229
SP - 199-206.e4
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -