Prenatal food supplementation fortified with multiple micronutrients increases birth length: a randomized controlled trial in rural Burkina Faso.
BACKGROUND
Prenatal multiple micronutrient (MMN) or balanced energy and protein supplementation has a limited effect on birth size of the offspring.


OBJECTIVE
The objective was to determine whether a prenatal MMN-fortified food supplement (FFS) improves anthropometric measures at birth compared with supplementation with an MMN pill alone.


METHODS
We conducted a nonblinded, individually randomized controlled trial in 1296 pregnant women in 2 villages in rural Burkina Faso. Supplements were provided on a daily basis, and compliance was closely verified by using a community-based network of home visitors.


RESULTS
Anthropometric measures at birth were available for analysis for 87% of the 1175 live singleton deliveries enrolled. After adjustment for gestational age at birth, the FFS group had a significantly higher birth length (+4.6 mm; P = 0.001). FFS supplementation resulted in a modestly higher birth weight (+31 g; P = 0.197). Subgroup analyses showed clinically important treatment effects on birth length (+12.0 mm; P = 0.005) and on birth weight (+111 g; P = 0.133) for underweight [body mass index (in kg/m(2)) <18.5] pregnant women. Women with early pregnancy anemia who received FFS gave birth to longer newborns (+7.3 mm; P = 0.002) than did those who received MMN supplementation.


CONCLUSIONS
The provision of FFS to pregnant women resulted in higher birth length than did MMN supplementation. For women with a suboptimal prepregnancy nutritional status, MMN supplementation should be complemented with a balanced energy and protein supplement to produce a clinical effect on birth size. The trial was registered at clinicaltrials.gov as NCT00909974.
Huybregts
Lieven
L
Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.
Roberfroid
Dominique
D
Lanou
Hermann
H
Menten
Joris
J
Meda
Nicolas
N
Van Camp
John
J
Kolsteren
Patrick
P
D000328:Adult; D001724:Birth Weight; D001827:Body Height; D015992:Body Mass Index; D019587:Dietary Supplements; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007231:Infant, Newborn; D018977:Micronutrients / Q000008:administration & dosage*; D011247:Pregnancy
D018977:Micronutrients