Laeticia C Toe1, Kimberley P Bouckaert2, Kristof De Beuf3, Dominique Roberfroid4, Nicolas Meda5, Olivier Thas6, John Van Camp7, Patrick W Kolsteren2, Lieven F Huybregts8. 1. Departments of Food Safety and Food Quality and Centre Muraz, Ministry of Health, Bobo-Dioulasso, Burkina Faso; 2. Departments of Food Safety and Food Quality and Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; 3. Mathematical Modeling, Statistics, and Bioinformatics, and FIRE Statistical Consulting, Ghent University, Ghent, Belgium; 4. Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; 5. Centre Muraz, Ministry of Health, Bobo-Dioulasso, Burkina Faso; 6. Mathematical Modeling, Statistics, and Bioinformatics, and National Institute for Applied Statistics Research, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, Australia; and. 7. Departments of Food Safety and Food Quality and. 8. Departments of Food Safety and Food Quality and Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC L.Huybregts@cgiar.org.
Abstract
BACKGROUND: Maternal nutritional status is a major determinant of low birth weight and fluctuates across seasons. Seasonality may influence the outcome of prenatal nutrition interventions that aim to enhance fetal growth. OBJECTIVE: This study investigated seasonal modifications of the efficacy of a randomized controlled prenatal nutrition intervention trial in pregnant women to improve fetal growth in rural Burkina Faso. METHODS: The second Micronutriments et Santé de la Mère et de l'Enfant study compared a lipid-based nutrient supplement (LNS) fortified with multiple micronutrients (MMNs) to an MMN supplement. Truncated Fourier series were used to characterize seasonality in birth outcomes. Models that included the Fourier series and newborn and maternal characteristics were used to assess seasonal effect modifications of prenatal supplementation on birth outcomes. RESULTS:Birth weight, birth length, small for gestational age as a proxy for intrauterine growth retardation, and preterm birth were significantly related to date of birth and showed important seasonal variations. LNSs, which supply energy in addition to MMNs, resulted in a significant increase in birth length (+13.5 mm, 95% CI: 6.5, 20.5 mm) at the transition from rain to dry season (September to November) compared to MMNs alone. CONCLUSIONS: The climatologic and agricultural seasonal patterns in Burkina Faso affect the efficacy of prenatal LNSs on birth length. In this context, prenatal MMN supplementation programs should be complemented by energy supplementation during the annual rain season to promote fetal growth. This trial was registered at clinicaltrials.gov as NCT00909974.
RCT Entities:
BACKGROUND: Maternal nutritional status is a major determinant of low birth weight and fluctuates across seasons. Seasonality may influence the outcome of prenatal nutrition interventions that aim to enhance fetal growth. OBJECTIVE: This study investigated seasonal modifications of the efficacy of a randomized controlled prenatal nutrition intervention trial in pregnant women to improve fetal growth in rural Burkina Faso. METHODS: The second Micronutriments et Santé de la Mère et de l'Enfant study compared a lipid-based nutrient supplement (LNS) fortified with multiple micronutrients (MMNs) to an MMN supplement. Truncated Fourier series were used to characterize seasonality in birth outcomes. Models that included the Fourier series and newborn and maternal characteristics were used to assess seasonal effect modifications of prenatal supplementation on birth outcomes. RESULTS: Birth weight, birth length, small for gestational age as a proxy for intrauterine growth retardation, and preterm birth were significantly related to date of birth and showed important seasonal variations. LNSs, which supply energy in addition to MMNs, resulted in a significant increase in birth length (+13.5 mm, 95% CI: 6.5, 20.5 mm) at the transition from rain to dry season (September to November) compared to MMNs alone. CONCLUSIONS: The climatologic and agricultural seasonal patterns in Burkina Faso affect the efficacy of prenatal LNSs on birth length. In this context, prenatal MMN supplementation programs should be complemented by energy supplementation during the annual rain season to promote fetal growth. This trial was registered at clinicaltrials.gov as NCT00909974.
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