title: Maternal Micronutrient Supplementation and Long Term Health Impact in Children in Rural Bangladesh.
abstract: BACKGROUND
  Limited data is available on the role of prenatal nutritional status on the health of school-age children. We aimed to determine the impact of maternal micronutrient supplementation on the health status of Bangladeshi children.
  
  
  METHODS
  Children (8.6-9.6 years; n = 540) were enrolled from a longitudinal mother-child cohort, where mothers were supplemented daily with either 30mg iron and 400μg folic acid (Fe30F), or 60mg iron and 400μg folic acid (Fe60F), or Fe30F including 15 micronutrients (MM), in rural Matlab. Blood was collected from children to determine the concentration of hemoglobin (Hb) and several micronutrients. Anthropometric and Hb data from these children were also available at 4.5 years of age and mothers at gestational week (GW) 14 and 30.
  
  
  RESULTS
  MM supplementation significantly improved (p≤0.05) body mass index-for-age z-score (BAZ), but not Hb levels, in 9 years old children compared to the Fe30F group. MM supplementation also reduced markers of inflammation (p≤0.05). About 28%, 35% and 23% of the women were found to be anemic at GW14, GW30 and both time points, respectively. The prevalence of anemia was 5% and 15% in 4.5 and 9 years old children, respectively. The adjusted odds of having anemia in 9 year old children was 3-fold higher if their mothers were anemic at both GW14 and GW30 [Odds Ratio (OR) = 3.05; 95% Confidence Interval (CI) 1.42, 6.14, P = 0.002] or even higher if they were also anemic at 4.5 years of age [OR = 5.92; 95% CI 2.64, 13.25; P<0.001].
  
  
  CONCLUSIONS
  Maternal micronutrient supplementation imparted beneficial effects on child health. Anemia during pregnancy and early childhood are important risk factors for the occurrence of anemia in school-age children.
authors.affiliation: Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.|Department of Immunology, Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh.
authors.forename: Tania
authors.initials: T
authors.lastname: Mannan
authors.affiliation: Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
authors.forename: Sultan
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
authors.forename: Evana
authors.initials: E
authors.lastname: Akhtar
authors.affiliation: Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
authors.forename: Anjan Kumar
authors.initials: AK
authors.lastname: Roy
authors.affiliation: Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
authors.forename: Md Ahsanul
authors.initials: MA
authors.lastname: Haq
authors.affiliation: Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
authors.forename: Adity
authors.initials: A
authors.lastname: Roy
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Kippler
authors.affiliation: International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Eva-Charlotte
authors.initials: EC
authors.lastname: Ekström
authors.affiliation: Department of Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Wagatsuma
authors.affiliation: Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
authors.forename: Rubhana
authors.initials: R
authors.lastname: Raqib
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D000067576:Child Health / Q000706:statistics & numerical data*; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006130:Growth Disorders / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D018977:Micronutrients / Q000097:blood / Q000627:therapeutic use*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012424:Rural Population / Q000706:statistics & numerical data
chemical_list: D006454:Hemoglobins; D018977:Micronutrients; D005492:Folic Acid; D007501:Iron