title: Providing lipid-based nutrient supplement during pregnancy does not reduce the risk of maternal P falciparum parasitaemia and reproductive tract infections: a randomised controlled trial.
abstract: Maternal infections are associated with maternal and foetal adverse outcomes. Nutrient supplementation during pregnancy may reduce the occurrence of infections by improving maternal immunity. We aimed to investigate the impact of small-quantity lipid-based nutrient supplement (SQ-LNS) on the occurrence of Plasmodium falciparum parasitaemia during pregnancy and trichomoniasis, vaginal candidiasis and urinary tract infection (UTI) after delivery.
  
  
  
  Pregnant Malawian women enrolled in the iLiNS-DYAD trial receiving daily supplementation with SQ-LNS, multiple micronutrients (MMN) or iron & folic acid (IFA) from <20 gestation weeks (gw) were assessed for P. falciparum parasitaemia at 32 gw using rapid diagnostic testing (RDT), at 36 gw using polymerase chain reaction (PCR) and at delivery using both RDT and PCR; and at one week after delivery for trichomoniasis and vaginal candidiasis using wet mount microscopy and for UTI using urine dipstick analysis. The prevalence of each infection by intervention group was estimated at the prescribed time points and the global null hypothesis was tested using logistic regression. Adjusted analyses were performed using preselected covariates.
  
  
  
  The prevalence of P. falciparum parasitaemia was 10.7% at 32 gw, 9% at 36 gw, and 8.3% by RDT and 20.2% by PCR at delivery. After delivery the prevalence of trichomoniasis was 10.5%, vaginal candidiasis was 0.5%, and UTI was 3.1%. There were no differences between intervention groups in the prevalence of any of the infections.
  
  
  
  In this population, SQ-LNS did not influence the occurrence of maternal P. falciparum parasitaemia, trichomoniasis, vaginal candidiasis or UTI.
  
  
  
  Identifier: NCT01239693 (10 November 2010).
authors.affiliation: University of Tampere School of Medicine, University of Tampere, Arvo building, FI-33014, Tampere, Finland.
authors.forename: Minyanga
authors.initials: M
authors.lastname: Nkhoma
authors.affiliation: University of Tampere School of Medicine, University of Tampere, Arvo building, FI-33014, Tampere, Finland.|Department of Pediatrics, Tampere University Hospital, FI-33521, Tampere, Finland.
authors.forename: Per
authors.initials: P
authors.lastname: Ashorn
authors.affiliation: University of Tampere School of Medicine, University of Tampere, Arvo building, FI-33014, Tampere, Finland.
authors.forename: Ulla
authors.initials: U
authors.lastname: Ashorn
authors.affiliation: Department of Nutrition, University of California, One Shields Ave., Davis, CA, 95616-8669, USA.
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dewey
authors.affiliation: University of Tampere School of Medicine, University of Tampere, Arvo building, FI-33014, Tampere, Finland.
authors.forename: Austrida
authors.initials: A
authors.lastname: Gondwe
authors.affiliation: School of Public Health and Family Medicine, College of Medicine, Mahatma Gandhi Road, Blantyre, Malawi.
authors.forename: John
authors.initials: J
authors.lastname: Mbotwa
authors.affiliation: Department of Medicine at the Peter Doherty Institute, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Rogerson
authors.affiliation: Division of Infectious Diseases and International Health, Duke University Medical Center, Box 102359 DUMC, Durham, NC, 27705, USA.|Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599-7435, USA.
authors.forename: Steve M
authors.initials: SM
authors.lastname: Taylor
authors.affiliation: School of Public Health and Family Medicine, College of Medicine, Mahatma Gandhi Road, Blantyre, Malawi. kmaleta@medcol.mw.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Maleta
mesh_terms: D000328:Adult; D000818:Animals; D019587:Dietary Supplements; D005260:Female; D005865:Gestational Age; D006801:Humans; D008055:Lipids / Q000008:administration & dosage*; D016778:Malaria, Falciparum / Q000469:parasitology / Q000517:prevention & control*; D018977:Micronutrients / Q000008:administration & dosage*; D018512:Parasitemia / Q000469:parasitology / Q000517:prevention & control*; D010963:Plasmodium falciparum / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology / Q000517:prevention & control*; D015597:Pregnancy Complications, Parasitic; D060737:Reproductive Tract Infections / Q000628:therapy*
chemical_list: D008055:Lipids; D018977:Micronutrients
keywords: Micronutrients; Plasmodium falciparum; Pregnancy; Reproductive tract infections; Urinary tract infection