Effect of maternal prenatal food supplementation, gestational weight gain, and breast-feeding on infant growth during the first 24 months of life in rural Vietnam

Phi N Quyen, Hoang T Nga, Benjamin Chaffee, Tu Ngu, Janet C King, Phi N Quyen, Hoang T Nga, Benjamin Chaffee, Tu Ngu, Janet C King

Abstract

Growth faltering among children during the first five years of life is a common problem among low and middle-income countries. The purpose of this study was to determine the effect of a nutrient-rich, food-based supplement given to Vietnamese rural women prior to and/or during pregnancy on the growth of their infants during first 24 months of life and to identify maternal and newborn factors associated with the infant's growth. This prospective cohort study included 236 infants born to mothers who had received nutritional advice or a food supplement from pre-conception to term or from mid-gestation to term as part of a prior randomized controlled trial. Infant anthropometry and feeding information were monitored monthly and the infant weight for age Z-score (WAZ), length for age Z-score (LAZ), and weight for length Z-score (WLZ) were assessed at 6, 12, 18, and 24 months of age using mixed-effects regression modeling. Compared to the non-supplemented mothers, infants born to mothers receiving food supplementation from mid-gestation to term had significantly higher WLZ only at 18 months (p = 0.03) and did not differ in other outcomes. Supplementation from pre-conception to term did not affect infant growth at any time point during the first 24 months. In the entire study cohort, maternal height and gestational weight gain were positively associated with the infant's WAZ and LAZ from 6 to 24 months of age. Programs designed to improve gestational weight gain among women performing demanding physical work throughout a reproductive cycle may improve postnatal infant growth. Trial registration: Registered Clinical Trials.Gov: NCT01235767.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flow diagram of participant progress…
Fig 1. Flow diagram of participant progress throughout the VINAVAC study.
Fig 2
Fig 2
Predicted Weight-for-age (a), Length-for-age (b), Weight-for-length (c) and Head circumference (d) Z-scores from Birth to 24 Months of Age.

References

    1. Ashorn P, Alho L, Ashorn U, Cheung YB, Dewey KG, Gondwe A, et al.: Supplementation of Maternal Diets during Pregnancy and for 6 Months Postpartum and Infant Diets Thereafter with Small-Quantity Lipid-Based Nutrient Supplements Does Not Promote Child Growth by 18 Months of Age in Rural Malawi: A Randomized Controlled Trial. J Nutr 2015, 145:1345–1353. 10.3945/jn.114.207225
    1. Roberfroid D, Huybregts L, Lanou H, Ouedraogo L, Henry MC, Meda N, et al. Impact of prenatal multiple micronutrients on survival and growth during infancy: a randomized controlled trial. Am J Clin Nutr 2012, 95:916–924. 10.3945/ajcn.111.029033
    1. Lanou H, Huybregts L, Roberfroid D, Nikiema L, Kouanda S, Van Camp J, et al. Prenatal nutrient supplementation and postnatal growth in a developing nation: an RCT. Pediatrics 2014, 133:e1001–1008. 10.1542/peds.2013-2850
    1. Hanieh S, Ha TT, Simpson JA, Thuy TT, Khuong NC, Thoang DD, et al. Postnatal growth outcomes and influence of maternal gestational weight gain: a prospective cohort study in rural Vietnam. BMC Pregnancy Childbirth 2014, 14:339 10.1186/1471-2393-14-339
    1. Kusin JA, Kardjati S, Houtkooper JM, Renqvist UH: Energy supplementation during pregnancy and postnatal growth. Lancet 1992, 340(8820):623–626. 10.1016/0140-6736(92)92168-f
    1. Khan AI, Kabir I, Ekstrom EC, Asling-Monemi K, Alam DS, Frongillo EA, et al. Effects of prenatal food and micronutrient supplementation on child growth from birth to 54 months of age: a randomized trial in Bangladesh. Nutr J 2011, 10:134 10.1186/1475-2891-10-134
    1. Institute of Medicine: Weight gain during pregnancy: Reexamining the Guidelines. Washington, D.C.: The National Academies Press; 2009.
    1. Heerman WJ, Bian A, Shintani A, Barkin SL: Interaction between maternal prepregnancy body mass index and gestational weight gain shapes infant growth. Acad Pediatr 2014, 14:463–470. 10.1016/j.acap.2014.05.005
    1. Li C, Zeng L, Wang D, Dang S, Chen T, Watson V, et al. Effect of maternal pre-pregnancy BMI and weekly gestational weight gain on the development of infants. Nutr J 2019, 18:6.
    1. Devakumar D, Fall CH, Sachdev HS, Margetts BM, Osmond C, Wells JC, et al. Maternal antenatal multiple micronutrient supplementation for long-term health benefits in children: a systematic review and meta-analysis. BMC Med 2016, 14:90 10.1186/s12916-016-0633-3
    1. Haider BA, Bhutta ZA: Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev 2017, 4:Cd004905 10.1002/14651858.CD004905.pub5
    1. Imdad A, Bhutta ZA: Maternal nutrition and birth outcomes: effect of balanced protein-energy supplementation. Paediatr Perinat Epidemiol 2012, 26 Suppl 1:178–190.
    1. Lechtig A, Yarbrough C, Delgado H, Habicht JP, Martorell R, Klein RE: Influence of maternal nutrition on birth weight. Am J Clin Nutr 1975, 28:1223–1233. 10.1093/ajcn/28.11.1223
    1. Stevens B, Buettner P, Watt K, Clough A, Brimblecombe J, Judd J: The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis. Matern Child Nutr 2015, 11:415–432. 10.1111/mcn.12183
    1. Wahlqvist M: The nutritionist victor of the Vietnam War. World Nutrition 2015, 6:613–622.
    1. Nga HT, Quyen PN, Chaffee BW, Diep Anh NT, Ngu T, King JC: Effect of a nutrient-rich, food-based supplement given to rural Vietnamese mothers prior to and/or during pregnancy on birth outcomes: a randomized controlled trial PLOS ONE 2020. In Press.
    1. Roberfroid D, Huybregts L, Lanou H, Ouedraogo L, Henry MC, Meda N, et al. MISAME study group. Impact of prenatal multiple micronutrients on survival and growth during infancy: a randomized controlled trial. Am J Clin Nutr. 2012,95(4):916–24. 10.3945/ajcn.111.029033
    1. Villar J, Giuliani F, Fenton TR, Ohuma EO, Ismail LC, Kennedy SH: INTERGROWTH-21st very preterm size at birth reference charts. Lancet 2016, 387:844–845. 10.1016/S0140-6736(16)00384-6
    1. Gibson RS: Principles of Nutritional Assessment. 2nd edn New York: Oxford University Press; 2005.
    1. World Health Organization: WHO Anthro and Macros. version 3.2.2 edn. Geneva: World Health Organization; 2011.
    1. World Health Organization: The WHO Child Growth Standards. Geneva: World Health Organization; 2006.
    1. Dewey K: Reducing stunting by improving maternal, infant and young child nutrition in regions such as South Asia: evidence, challenges, and opportunities. Matern Child Health J 2016, 12:27–38.
    1. Hambidge K : A multi-country randomized controlled trial of comprehensive maternal nutrition supplementation initiated preconception: the Women First Trial. Am J Cin Nutr 2019.
    1. Hall AG, Ngu T, Nga HT, Quyen PN, Hong Anh PT, King JC : An Animal-Source Food Supplement Increases Micronutrient Intakes and Iron Status among Reproductive-Age Women in Rural Vietnam. J Nutr 2017, 147:1200–1208. 10.3945/jn.116.241968
    1. Vietnam WB: Well done, not yet done: Vietnam’s Remarkable Progress on Poverty Reduction and the Emerging Challenges.2012.
    1. Le Nguyen BK, Le Thi H, Nguyen Do VA, Tran Thuy N, Nguyen Huu C, Thanh Do T, et al. Double burden of undernutrition and overnutrition in Vietnam in 2011: results of the SEANUTS study in 0.5-11-year-old children. Br J Nutr 2013, 110 Suppl 3:S45–56.
    1. Diesel JC, Eckhardt CL, Day NL, Brooks MM, Arslanian SA, Bodnar LM: Gestational Weight Gain and Offspring Longitudinal Growth in Early Life. Ann Nutr Metab 2015, 67:49–57. 10.1159/000437149
    1. Deierlein AL, Siega-Riz AM, Herring AH, Adair LS, Daniels JL : Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 years. Pediatr Obes 2012, 7:134–142.
    1. Young MF, Nguyen PH, Gonzalez Casanova I, Addo OY, Tran LM, Nguyen S, et al. Role of maternal preconception nutrition on offspring growth and risk of stunting across the first 1000 days in Vietnam: A prospective cohort study. PLoS One 2018, 13:e0203201 10.1371/journal.pone.0203201
    1. Young MF, Hong Nguyen P, Addo OY, Pham H, Nguyen S, Martorell R, et al. Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam. PLoS One 2017, 12:e0170192 10.1371/journal.pone.0170192
    1. Wieringa FT, Dijkhuizen MA, Muhilal, Van der Meer JW : Maternal micronutrient supplementation with zinc and beta-carotene affects morbidity and immune function of infants during the first 6 months of life. Eur J Clin Nutr 2010, 64:1072–1079.

Source: PubMed

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