Increased birthweight after prenatal dietary supplementation of rural African women.
Birthweight data from 197 rural Gambian women who received an energy-dense prenatal dietary supplement over a 4-y period (net intake = 430 kcal/d) was compared with data from 182 women from 4 baseline years. Preintervention birthweights averaged 2944 +/- 43 (SEM) g when women were in positive energy balance during the dry harvest season (pregnancy weight gain greater than 1200 g/mo). Birthweights decreased to 2808 +/- 41 g (p less than 0.01) in the wet season when food shortages and agricultural work caused negative energy balance (weight gain less than 500 g/mo). There were no detectable secular trends in the baseline data. Supplementation was ineffective during the dry season but highly effective during the wet season: +225 +/- 56 g, p less than 0.001 (unadjusted) or +200 +/- 53 g, p less than 0.001 (adjusted for sex, season, and parity) by between-child multiple regression analysis; +231 +/- 65 g, p less than 0.001 by within-mother analysis. The proportion of low-birthweight babies (less than 2501 g) decreased from 23.7-7.5%, p less than 0.002. The observed threshold effect emphasizes the importance of selective targeting of interventions to truly at-risk groups.
Prentice
A M
AM
MRC Dunn Nutrition Unit, Cambridge, United Kingdom.
Cole
T J
TJ
Foord
F A
FA
Lamb
W H
WH
Whitehead
R G
RG
D000886:Anthropometry; D001724:Birth Weight; D004032:Diet; D005314:Embryonic and Fetal Development; D005260:Female; D005527:Food, Fortified; D005714:Gambia; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care; D012621:Seasons