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越南孕期补充多种微量营养素的效果试验:对出生体重及约2岁儿童发育迟缓的影响

An effectiveness trial of multiple micronutrient supplementation during pregnancy in Vietnam: impact on birthweight and on stunting in children at around 2 years of age.

作者信息

Huy Nguyen Do, Le Hop Thi, Shrimpton Roger, Hoa Cao Viet

机构信息

National Institute of Nutrition, Hanoi, Vietnam.

出版信息

Food Nutr Bull. 2009 Dec;30(4 Suppl):S506-16. doi: 10.1177/15648265090304S405.

Abstract

BACKGROUND

Multiple micronutrient deficiencies during pregnancy in Vietnam may contribute to poor fetal growth and stunting, which are major determinants of the health and development offuture generations.

OBJECTIVE

We assessed the effects of prenatal multiple micronutrient supplementation on maternal weight gain during pregnancy, infant birthweight, and height of the child at around 2 years of age.

METHODS

We conducted a nonrandomized, non-blinded, side-by-side effectiveness trial in a normal program setting in three districts in the Red River Delta in the north of Vietnam. Women in one district received the standard iron-folic acid supplement during prenatal care; women in the second district received the multiple micronutrient supplement; in the third district, gender training was provided in addition to the multiple micronutrient supplement. Cluster surveys were carried out in the three districts at the end of the trial to verify low birthweight (LBW) and at around 2 years after the trial to measure children's height and weight, as well as to collect demographic data on the mothers.

RESULTS

Mean birthweight was higher in the districts receiving multiple micronutrient supplements than in the district receiving iron-folic acid tablets. The mean birthweight was 166 g higher in the district receiving multiple micronutrients and 105 g higher in the district receiving multiple micronutrients with gender training than in the district receiving iron-folic acid (p < .05). The prevalence of LBW children (< 2500 g) was lower in the district receiving multiple micronutrients (4.0%) and the district receiving multiple micronutrients plus gender training (5.8%) than in the district receiving iron-folic acid (10.6%) (p < .05). Children at around 2 years of age were taller in the district receiving multiple micronutrients (82.66 cm) and the district receiving multiple micronutrients plus gender training (83.61 cm) than in the district receiving iron-folic acid (81.64 cm), and the stunting rates were about 10% lower than in the district receiving iron-folic acid.

CONCLUSIONS

Multiple micronutrient supplementation during pregnancy could be an important intervention to help reduce stunting rates in Vietnam.

摘要

背景

越南孕期多种微量营养素缺乏可能导致胎儿生长发育不良和发育迟缓,而这是影响后代健康与发育的主要因素。

目的

我们评估了孕期补充多种微量营养素对孕期母亲体重增加、婴儿出生体重以及儿童2岁左右身高的影响。

方法

我们在越南北部红河三角洲的三个地区的常规项目环境中开展了一项非随机、非盲法、平行对照的有效性试验。一个地区的妇女在产前保健期间接受标准铁叶酸补充剂;第二个地区的妇女接受多种微量营养素补充剂;在第三个地区,除多种微量营养素补充剂外还提供了性别培训。试验结束时在这三个地区进行整群调查以核实低出生体重情况,并在试验后约2年测量儿童的身高和体重,同时收集母亲的人口统计学数据。

结果

接受多种微量营养素补充剂的地区的平均出生体重高于接受铁叶酸片的地区。接受多种微量营养素的地区的平均出生体重比接受铁叶酸的地区高166克,接受多种微量营养素加性别培训的地区的平均出生体重比接受铁叶酸的地区高105克(p<.05)。接受多种微量营养素的地区(4.0%)和接受多种微量营养素加性别培训的地区(5.8%)的低出生体重儿童(<2500克)患病率低于接受铁叶酸的地区(10.6%)(p<.05)。接受多种微量营养素的地区(82.66厘米)和接受多种微量营养素加性别培训的地区(83.61厘米)中2岁左右的儿童比接受铁叶酸的地区(81.64厘米)的儿童更高,发育迟缓率比接受铁叶酸的地区低约10%。

结论

孕期补充多种微量营养素可能是帮助降低越南发育迟缓率的一项重要干预措施。

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