Loughborough University
Leicestershire, UK
LE11 3TU
+44 (0)1509 263171
Loughborough University

Loughborough University Institutional Repository

Please use this identifier to cite or link to this item: https://dspace.lboro.ac.uk/2134/22191

Title: Association of a prenatal lipid-based nutritional supplement with fetal growth in rural Gambia: the Early Nutrition and Immune Development randomized controlled trial (ISRCTN49285450)
Authors: Johnson, William O.
Darboe, M.K.
Sosseh, F.
Nshe, P.
Prentice, A.M.
Moore, S.E.
Keywords: Lipid-based nutritional supplement
Fetal growth
The Gambia
Seasonality
Gestational weight gain
Randomized control trial
Issue Date: 2016
Publisher: © Wiley
Citation: JOHNSON, W.O. ...et al., 2016. Association of a prenatal lipid-based nutritional supplement with fetal growth in rural Gambia: the Early Nutrition and Immune Development randomized controlled trial (ISRCTN49285450). Maternal and Child Nutrition, In Press.
Abstract: Prenatal supplementation with protein-energy (PE) and/or multiple-micronutrients (MMN) may improve fetal growth, but trials of lipid-based nutritional supplements (LNS) have reported inconsistent results. We conducted a post-hoc analysis of non-primary outcomes in a trial in Gambia, with the aim to test the associations of LNS with fetal growth and explore how efficacy varies depending on nutritional status. The sample comprised 620 pregnant women in an individually randomized, partially blinded trial with four arms: 1) iron and folic acid (FeFol) tablet (usual care, referent group), 2) MMN tablet, 3) PE LNS, and 4) PE + MMN LNS. Analysis of variance examined unadjusted differences in fetal biometry Z-scores at 20 and 30 weeks and neonatal anthropometry Z-scores, while regression tested for modification of intervention-outcome associations by season and maternal height, BMI, and weight gain. Despite evidence of between-arm differences in some fetal biometry, Z-scores at birth were not greater in the intervention arms than the FeFol arm (e.g., birth weight Z-scores: FeFol -0.71, MMN -0.63, PE -0.64, PE + MMN -0.62; group-wise p = 0.796). In regression analyses, intervention associations with birth weight and head circumference were modified by maternal weight gain between booking and 30 weeks gestation (e.g., PE + MMN associations with birth weight were + 0.462 Z-scores (95% CI 0.097, 0.826) in the highest quartile of weight gain but - 0.099 Z-scores (-0.459, 0.260) in the lowest). In conclusion, we found no strong evidence that a prenatal LNS intervention was associated with better fetal growth in the whole sample.
Description: This paper is in closed access until 12 months after publication.
Version: Accepted for publication
URI: https://dspace.lboro.ac.uk/2134/22191
Publisher Link: http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1740-8709
ISSN: 1740-8709
Appears in Collections:Closed Access (Sport, Exercise and Health Sciences)

Files associated with this item:

File Description SizeFormat
Johnson et al. ENID. MCN. revised.pdfAccepted version197 kBAdobe PDFView/Open

 

SFX Query

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.