College of Public Health, Medical and Veterinary Sciences, James Cook University, QLD, Townsville, Australia.
Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia.
BMC Pregnancy Childbirth. 2018 Jul 4;18(1):286. doi: 10.1186/s12884-018-1915-x.
Prenatal balanced protein energy supplementation consumed by undernourished women improves mid-upper arm circumference in early infancy. This study aimed to identify whether locally produced maternal food-based supplementation improved anthropometric measures at birth and early infancy.
A village-matched evaluation, applying principles of a cluster randomised controlled trial, of a locally produced supplemental food to 87 undernourished pregnant women. 12 villages (intervention: n = 8; control: n = 4) in Pirganj sub-district, Rangpur District, northern Bangladesh. Daily supplements were provided.
Anthropometric data at birth were available for 77 mother-infant dyads and longer-term infant growth data for 75 infants. Mid-upper arm circumference (MUAC) was significantly larger in infants of mothers in the intervention group compared with the control group at 6 months (p < 0.05). The mean birth weight in babies of supplemented mothers (mean: 2·91 kg; SD: 0·19) was higher than in babies of mothers in the control group (mean: 2·72 kg; SD: 0·13), and these changes persisted until 6 months. Also, the proportion of low birth weight babies in the intervention group was much lower (event rate = 0.04) than in the control group (event rate = 0.16). However, none of these differences were statistically significant (p > 0·05; most likely due to small sample size). The intervention reduced the risk of wasting at 6 months by 63.38% (RRR = 0.6338), and of low birth weight by 88·58% (RRR = 0.8858), with NNT of 2.22 and 6.32, respectively. Only three pregnant women require this intervention in order to prevent wasting at 6 months in one child, and seven need the intervention to prevent low birth weight of one child.
Locally produced food-based balanced protein energy supplementation in undernourished pregnant women in northern Bangladesh resulted in larger MUAC in infants at 6 months. Further research, with larger sample sizes, is required to confirm the role of locally produced supplementation for undernourished pregnant women on weight and linear growth in newborns and infants.
This research was registered with the ISRCTN registry (ISRCTN97447076). This project had human research ethical approval from the James Cook University (Australia) Ethics committee (H4498) and the Bangladesh Medical Research Council (BMRC/NREC/2010-2013/58).
营养不良的女性在孕期摄入的平衡蛋白质能量补充剂可改善婴儿早期的中上臂围。本研究旨在确定本地生产的基于食物的补充剂是否可改善出生和婴儿早期的人体测量指标。
在孟加拉国北部朗布尔地区皮尔甘杰分区的 12 个村庄（干预组：n=8；对照组：n=4），应用集群随机对照试验的原理，对 87 名营养不良的孕妇进行了当地生产的补充食物的村配对评估。每日提供补充剂。
77 对母婴在出生时可提供人体测量数据，75 名婴儿可提供更长期的婴儿生长数据。干预组婴儿的中上臂围（MAC）在 6 个月时明显大于对照组（p<0.05）。补充母亲的婴儿出生体重平均值（均值：2.91kg；SD：0.19）高于对照组母亲的婴儿（均值：2.72kg；SD：0.13），这些变化一直持续到 6 个月。此外，干预组低出生体重儿的比例也明显较低（发生率=0.04），而对照组的发生率为 0.16。但是，这些差异均无统计学意义（p>0.05；很可能是由于样本量小）。该干预措施可使 6 个月时的消瘦风险降低 63.38%（RRR=0.6338），低出生体重风险降低 88.58%（RRR=0.8858），NNT 分别为 2.22 和 6.32。为了预防一个孩子在 6 个月时消瘦，只需对 3 名孕妇进行这种干预，而为了预防一个孩子低出生体重，只需对 7 名孕妇进行这种干预。
在孟加拉国北部营养不良的孕妇中，摄入本地生产的基于食物的平衡蛋白质能量补充剂可使 6 个月大的婴儿的 MAC 更大。需要进一步的研究，以更大的样本量来确认对营养不良的孕妇进行本地补充对新生儿和婴儿的体重和线性生长的作用。
本研究在 ISRCTN 注册中心（ISRCTN83634312）进行了注册。该项目获得了澳大利亚詹姆斯库克大学（James Cook University）伦理委员会（H4498）和孟加拉国医学研究理事会（Bangladesh Medical Research Council，BMRC/NREC/2010-2013/58）的人类研究伦理批准。
