Kusin J A, Kardjati S, Houtkooper J M, Renqvist U H
Nutrition Section, Royal Tropical Institute, Amsterdam, Netherlands.
Lancet. 1992 Sep 12;340(8820):623-6. doi: 10.1016/0140-6736(92)92168-f.
The effect of improving maternal nutrition during pregnancy on growth of the child has not been assessed, since previous studies supplemented the diets of children as well as mothers. In a controlled randomised trial in Madura, East Java, pregnant women received a high (HE) or low (LE) energy supplement that provided 1950 kJ (465 kcal) or 218 kJ (52 kcal), respectively, in the last trimester of pregnancy. The effect of this intervention on the children's growth was assessed longitudinally for the first 5 years of life. Only the children of mothers who had complied for at least 90 days were included. Infants entered the study at birth and their growth was measured at 4-week intervals until 12 months old; thereafter they were measured every 3 months. Growth curves were calculated from a mathematical model, based on the best fit of actual measurements and the age-related growth velocity. Up to the age of 24 months, HE children were significantly heavier than LE children (p less than 0.05). HE children were also taller throughout the first 5 years (p less than 0.005 from 15 to 48 months, p less than 0.05 at both 3-12 and 60 months). Weight-for-height by age was similar in both groups, but stunting (height-for-age) was less prevalent in HE children. In a community characterised by chronic energy deficiency among women of reproductive age, energy supplementation of women for the last 90 days of pregnancy was effective in the promotion of postnatal growth and reduction in malnutrition of preschool children.
孕期改善孕产妇营养对儿童生长的影响尚未得到评估,因为以往的研究对儿童和母亲的饮食都进行了补充。在东爪哇省马都拉进行的一项对照随机试验中,孕妇在妊娠晚期分别接受了高能量(HE)或低能量(LE)补充剂,分别提供1950千焦(465千卡)或218千焦(52千卡)。对这一干预措施对儿童出生后前5年生长的影响进行了纵向评估。仅纳入了母亲至少依从90天的儿童。婴儿在出生时进入研究,在12个月大之前每4周测量一次生长情况;此后每3个月测量一次。生长曲线是根据一个数学模型计算得出的,该模型基于实际测量值与年龄相关生长速度的最佳拟合。在24个月龄之前,HE组儿童明显比LE组儿童更重(p小于0.05)。在整个前5年中,HE组儿童也更高(15至48个月时p小于0.005,3至12个月和60个月时p均小于0.05)。两组按年龄计算的身高别体重相似,但HE组儿童发育迟缓(年龄别身高)的发生率较低。在一个以育龄妇女慢性能量缺乏为特征的社区中,在妊娠最后90天对妇女进行能量补充对促进学龄前儿童出生后生长和减少营养不良有效。