Toe Laeticia C, Bouckaert Kimberley P, De Beuf Kristof, Roberfroid Dominique, Meda Nicolas, Thas Olivier, Van Camp John, Kolsteren Patrick W, Huybregts Lieven F
Departments of Food Safety and Food Quality and Centre Muraz, Ministry of Health, Bobo-Dioulasso, Burkina Faso;
Departments of Food Safety and Food Quality and Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;
J Nutr. 2015 Mar;145(3):634-9. doi: 10.3945/jn.114.203448. Epub 2015 Jan 14.
Maternal nutritional status is a major determinant of low birth weight and fluctuates across seasons. Seasonality may influence the outcome of prenatal nutrition interventions that aim to enhance fetal growth.
This study investigated seasonal modifications of the efficacy of a randomized controlled prenatal nutrition intervention trial in pregnant women to improve fetal growth in rural Burkina Faso.
The second Micronutriments et Santé de la Mère et de l'Enfant study compared a lipid-based nutrient supplement (LNS) fortified with multiple micronutrients (MMNs) to an MMN supplement. Truncated Fourier series were used to characterize seasonality in birth outcomes. Models that included the Fourier series and newborn and maternal characteristics were used to assess seasonal effect modifications of prenatal supplementation on birth outcomes.
Birth weight, birth length, small for gestational age as a proxy for intrauterine growth retardation, and preterm birth were significantly related to date of birth and showed important seasonal variations. LNSs, which supply energy in addition to MMNs, resulted in a significant increase in birth length (+13.5 mm, 95% CI: 6.5, 20.5 mm) at the transition from rain to dry season (September to November) compared to MMNs alone.
The climatologic and agricultural seasonal patterns in Burkina Faso affect the efficacy of prenatal LNSs on birth length. In this context, prenatal MMN supplementation programs should be complemented by energy supplementation during the annual rain season to promote fetal growth. This trial was registered at clinicaltrials.gov as NCT00909974.
孕产妇营养状况是低出生体重的主要决定因素，且随季节波动。季节变化可能会影响旨在促进胎儿生长的产前营养干预措施的效果。
本研究调查了在布基纳法索农村地区进行的一项随机对照产前营养干预试验对改善胎儿生长的疗效的季节性变化。
第二项母婴微量营养素与健康研究将添加多种微量营养素（MMN）的脂质基营养补充剂（LNS）与MMN补充剂进行了比较。采用截断傅里叶级数来描述出生结局的季节性。使用包含傅里叶级数以及新生儿和母亲特征的模型来评估产前补充剂对出生结局的季节性效应变化。
出生体重、出生身长、作为宫内生长迟缓指标的小于胎龄儿以及早产与出生日期显著相关，并呈现出重要的季节性变化。与单独使用MMN相比，在从雨季过渡到旱季（9月至11月）时，除MMN外还提供能量的LNS使出生身长显著增加（增加13.5毫米，95%置信区间：6.5，20.5毫米）。
布基纳法索的气候和农业季节性模式会影响产前LNS对出生身长的疗效。在此背景下，产前MMN补充计划应在每年雨季辅以能量补充，以促进胎儿生长。本试验已在clinicaltrials.gov注册，注册号为NCT00909974。
