Seasonality modifies the effect of a lipid-based nutrient supplement for pregnant rural women on birth length.
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.
Departments of Food Safety and Food Quality and Centre Muraz, Ministry of Health, Bobo-Dioulasso, Burkina Faso;
Laeticia C
LC
Toe
Departments of Food Safety and Food Quality and Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;
Kimberley P
KP
Bouckaert
Mathematical Modeling, Statistics, and Bioinformatics, and FIRE Statistical Consulting, Ghent University, Ghent, Belgium;
Kristof
K
De Beuf
Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;
Dominique
D
Roberfroid
Centre Muraz, Ministry of Health, Bobo-Dioulasso, Burkina Faso;
Nicolas
N
Meda
Mathematical Modeling, Statistics, and Bioinformatics, and National Institute for Applied Statistics Research, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, Australia; and.
Olivier
O
Thas
Departments of Food Safety and Food Quality and.
John
J
Van Camp
Departments of Food Safety and Food Quality and Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;
Patrick W
PW
Kolsteren
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.
Lieven F
LF
Huybregts
D000328:Adult; D001724:Birth Weight; D002050:Burkina Faso; D019587:Dietary Supplements; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation; D005865:Gestational Age; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D018977:Micronutrients / Q000008:administration & dosage*; D009752:Nutritional Status; D011247:Pregnancy; D047928:Premature Birth; D039401:Prenatal Nutritional Physiological Phenomena; D012424:Rural Population; D055815:Young Adult
D018977:Micronutrients
Burkina Faso; birth length; birth weight; food supplement; pregnant women; premature birth; seasonal variations; small for gestational age