Multivitamin Supplementation Is Associated with Greater Adequacy of Gestational Weight Gain among Pregnant Women in Tanzania.


Journal

The Journal of nutrition
ISSN: 1541-6100
Titre abrégé: J Nutr
Pays: United States
ID NLM: 0404243

Informations de publication

Date de publication:
01 04 2022
Historique:
received: 21 10 2021
revised: 02 12 2021
accepted: 23 12 2021
pmc-release: 18 02 2024
pubmed: 30 12 2021
medline: 5 4 2022
entrez: 29 12 2021
Statut: ppublish

Résumé

Gestational weight gain (GWG) is a modifiable risk factor associated with adverse birth outcomes. Studies have shown that the provision of multiple micronutrient supplements to pregnant women reduces the risk of low birth weight. However, the effect of multiple micronutrient supplements on GWG has been understudied. We examined the effect of daily supplementation of pregnant women with multivitamins on GWG in relation to the GWG recommendation by the Institute of Medicine (IOM). Pregnant women with gestational age between 12 and 27 wk were randomly assigned to receive daily multivitamins or placebo until delivery. Weight was measured at enrollment and every follow-up visit. Percentage adequacy of GWG was calculated as actual GWG divided by the recommended GWG according to the IOM recommendation. Binary outcomes included severely inadequate (<70%), inadequate (<90%), and excessive GWG (≥125%). The analysis included 7573 women with singleton pregnancies. Multiple linear regression models were used to examine the association between multivitamin supplementation and percentage adequacy of GWG, and log-binomial models were used for binary outcomes. The mean percentage adequacy of GWG was 96.7% in the multivitamin arm and 94.4% in the placebo arm, with a mean difference of 2.3% (95% CI: 0.3%, 4.2%; P = 0.022). Compared with women in the placebo arm, those who received multivitamins had a lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.97; P = 0.008) and inadequate GWG (RR: 0.95; 95% CI: 0.91, 0.99; P = 0.018). No significant difference was found in excessive GWG. Multivitamin supplementation increased GWG and reduced the risk of severely inadequate and inadequate GWG among pregnant women in Tanzania. Together with previously reported beneficial effects of the supplements on birth outcomes in low- and middle-income countries, our findings support scaling up the use of prenatal supplements that include multivitamins in addition to iron and folic acid.This trial was registered at clinicaltrials.gov as NCT00197548.

Sections du résumé

BACKGROUND
Gestational weight gain (GWG) is a modifiable risk factor associated with adverse birth outcomes. Studies have shown that the provision of multiple micronutrient supplements to pregnant women reduces the risk of low birth weight. However, the effect of multiple micronutrient supplements on GWG has been understudied.
OBJECTIVES
We examined the effect of daily supplementation of pregnant women with multivitamins on GWG in relation to the GWG recommendation by the Institute of Medicine (IOM).
METHODS
Pregnant women with gestational age between 12 and 27 wk were randomly assigned to receive daily multivitamins or placebo until delivery. Weight was measured at enrollment and every follow-up visit. Percentage adequacy of GWG was calculated as actual GWG divided by the recommended GWG according to the IOM recommendation. Binary outcomes included severely inadequate (<70%), inadequate (<90%), and excessive GWG (≥125%). The analysis included 7573 women with singleton pregnancies. Multiple linear regression models were used to examine the association between multivitamin supplementation and percentage adequacy of GWG, and log-binomial models were used for binary outcomes.
RESULTS
The mean percentage adequacy of GWG was 96.7% in the multivitamin arm and 94.4% in the placebo arm, with a mean difference of 2.3% (95% CI: 0.3%, 4.2%; P = 0.022). Compared with women in the placebo arm, those who received multivitamins had a lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.97; P = 0.008) and inadequate GWG (RR: 0.95; 95% CI: 0.91, 0.99; P = 0.018). No significant difference was found in excessive GWG.
CONCLUSIONS
Multivitamin supplementation increased GWG and reduced the risk of severely inadequate and inadequate GWG among pregnant women in Tanzania. Together with previously reported beneficial effects of the supplements on birth outcomes in low- and middle-income countries, our findings support scaling up the use of prenatal supplements that include multivitamins in addition to iron and folic acid.This trial was registered at clinicaltrials.gov as NCT00197548.

Identifiants

pubmed: 34964890
pii: S0022-3166(22)00603-4
doi: 10.1093/jn/nxab448
pmc: PMC8970983
doi:
pii:

Substances chimiques

Vitamins 0

Banques de données

ClinicalTrials.gov
['NCT00197548']

Types de publication

Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1091-1098

Subventions

Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : NICHD R01 37701

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

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Auteurs

Enju Liu (E)

Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA.

Dongqing Wang (D)

Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.

Anne Marie Darling (AM)

Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.

Nandita Perumal (N)

Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.

Molin Wang (M)

Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.
Department of Biostatistics, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.

Willy Urassa (W)

Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Andrea Pembe (A)

Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Wafaie W Fawzi (WW)

Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.
Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.
Department of Nutrition, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.

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