title: Effects of pre- and postnatal nutrition interventions on child growth and body composition: the MINIMat trial in rural Bangladesh.
abstract: BACKGROUND
  Nutritional insults and conditions during fetal life and infancy influence subsequent growth and body composition of children.
  
  
  OBJECTIVE
  Effects of maternal food and micronutrient supplementation and exclusive breastfeeding counseling on growth of offspring aged 0-54 months and their body composition at 54 months of age were studied.
  
  
  METHODS
  In the MINIMat trial (ISRCTN16581394) in Matlab, Bangladesh, pregnant women were randomized to early (around 9 weeks) or usual invitation (around 20 weeks) to food supplementation and to one of the three daily micronutrient supplements: 30-mg Fe and 400-µg folic acid (Fe30F), 60-mg Fe and 400-µg folic acid (Fe60F), and multiple micronutrient supplements (MMS). The supplements were also randomized to exclusive breastfeeding (EBF) counseling or to usual health messages.
  
  
  RESULTS
  No differences in background characteristics were observed among the intervention groups. There was also no differential effect of prenatal interventions on birthweight or birthlength. Early food supplementation reduced the level of stunting from early infancy up to 54 months of age among boys (average difference - 6.5% units, 95% confidence interval [CI] 1.7-11.3, p=0.01) but not among girls (average difference - 2.4% units, 95% CI -2.2-7.0, p=0.31). MMS resulted in more stunting compared to standard Fe60F (average difference - 4.8% units, 95% CI 0.8-8.9, p=0.02). Breastfeeding counseling prolonged the duration of EBF (difference - 35 days, 95% CI 30.6-39.5, p<0.001). Neither pregnancy interventions nor breastfeeding counseling influenced the body composition of children at 54 months of age.
  
  
  CONCLUSIONS
  Early food supplementation during pregnancy reduced the occurrence of stunting among boys aged 0-54 months, while prenatal MMS increased the proportion of stunting. Food and micronutrient supplementation or EBF intervention did not affect body composition of offspring at 54 months of age. The effects of prenatal interventions on postnatal growth suggest programming effects in early fetal life.
authors: icddr,b, Dhaka, Bangladesh; Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden; ashrafk@icddrb.org.
authors: Ashraful
authors: A
authors: Islam Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D001724:Birth Weight; D001823:Body Composition / Q000502:physiology*; D001827:Body Height; D001942:Breast Feeding; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005492:Folic Acid / Q000494:pharmacology; D006130:Growth Disorders / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007229:Infant Welfare; D007231:Infant, Newborn; D007501:Iron / Q000494:pharmacology; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D008429:Maternal Welfare; D018977:Micronutrients / Q000494:pharmacology; D008875:Middle Aged; D011181:Postnatal Care; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D012424:Rural Population; D055815:Young Adult
chemical_list: D018977:Micronutrients; D005492:Folic Acid; D007501:Iron
keywords: body composition; child growth; food supplementation; multiple micronutrients; pregnancy