title: Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood: follow-up of a double-blind randomised controlled trial in Nepal.
abstract: A randomised trial of prenatal multiple micronutrient supplementation in Nepalese women increased birthweight and weight at 2 years of age in offspring, compared to those born to mothers who only received iron and folic acid supplements. Further follow-up of this cohort provided an opportunity to investigate the effect of antenatal multiple micronutrients on subsequent lung function by measuring spirometry at 7-9 years of age in C: hildren born during the trial. 841 children (80% of the cohort) were seen at mean±sd 8.5±0.4 years. Technically successful spirometry results were obtained in 793 (94.3%) children, 50% of whom had been randomised to micronutrient supplementation. Background characteristics, including anthropometry, were similar in the two allocation groups. Lung function was also similar, mean (95% CI) difference in z-scores (supplementation minus control) was -0.08 (-0.19-0.04), -0.05 (-0.17-0.06) and -0.04 (-0.15-0.07) for forced expiratory volume in 1 s (FEV1), forced vital capacity and FEV1/FVC, respectively. Compared with healthy white children, FEV1 and FVC in the "healthy" Nepalese children were ∼1 (∼13%) z-score lower, with no difference in FEV1/FVC. We conclude that, compared with routine iron and folic acid, multiple micronutrient supplementation during pregnancy has no effect on spirometric lung function in Nepalese children at 8.5 years of age.
authors.affiliation: Institute for Global Health, University College London, London, UK. d.devakumar@ucl.ac.uk.
authors.forename: Delan
authors.initials: D
authors.lastname: Devakumar
authors.affiliation: Respiratory, Critical Care and Anaesthesia Section (Portex Unit), Institute of Child Health, University College London, London, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Stocks
authors.affiliation: Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK.
authors.forename: Jon G
authors.initials: JG
authors.lastname: Ayres
authors.affiliation: Respiratory, Critical Care and Anaesthesia Section (Portex Unit), Institute of Child Health, University College London, London, UK. Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Kirkby
authors.affiliation: Mother and Infant Research Activities, Kathmandu, Nepal.
authors.forename: Sushil K
authors.initials: SK
authors.lastname: Yadav
authors.affiliation: Institute for Global Health, University College London, London, UK.
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Saville
authors.affiliation: Child Health Dept, University of Aberdeen, Royal Aberdeen Children's Hospital, Aberdeen, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
authors.affiliation: Childhood Nutrition Research Centre, Institute of Child Health, University College London, London, UK.
authors.forename: Jonathan C K
authors.initials: JC
authors.lastname: Wells
authors.affiliation: Mother and Infant Research Activities, Kathmandu, Nepal.
authors.forename: Dharma S
authors.initials: DS
authors.lastname: Manandhar
authors.affiliation: Institute for Global Health, University College London, London, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Costello
authors.affiliation: Institute for Global Health, University College London, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Osrin
mesh_terms: D000397:Air Pollution / Q000706:statistics & numerical data; D001724:Birth Weight; D001835:Body Weight; D002648:Child; D015331:Cohort Studies; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D016015:Logistic Models; D008168:Lung / Q000502:physiology* / Q000503:physiopathology; D008297:Male; D018977:Micronutrients / Q000627:therapeutic use*; D015999:Multivariate Analysis; D009390:Nepal; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D013147:Spirometry; D014131:Trace Elements / Q000627:therapeutic use; D014797:Vital Capacity; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D018977:Micronutrients; D014131:Trace Elements; D014815:Vitamins; D005492:Folic Acid; D007501:Iron