Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA 93407, USA.
Washington University School of Medicine, Washington University, St. Louis, MO 63110, USA.
Nutrients. 2018 Jul 7;10(7):879. doi: 10.3390/nu10070879.
Micronutrient deficiencies during pregnancy are common in Africa and can cause adverse outcomes. The objective was to measure micronutrient status and change in moderately malnourished pregnant Malawian women randomized to one of three nutritional interventions. Serum vitamin B, 25-hydroxyvitamin D, folate, retinol, ferritin, zinc, albumin and C-reactive protein were measured in pregnant women with MUAC ≥20.6 cm and ≤23.0 cm at enrollment ( = 343) and after 10 weeks ( = 229) of receiving: (1) ready-to-use supplementary food (RUSF); (2) fortified corn-soy blend (CSB+) with multiple-micronutrient supplement (CSB+UNIMMAP); or (3) CSB+ with iron and folic acid (CSB+IFA). Each provided 100⁻300% Recommended Dietary Allowance of most micronutrients and 900 kcal/day. Birth length was measured in 272 infants. Enrollment measurements indicated deficiencies in vitamin B (20.9%) and zinc (22.3%), low values of ferritin (25.1%) and albumin (33.7%), and elevated CRP (46.0%). Vitamin B is known to decrease in the third trimester; the RUSF group had the smallest decrease from enrollment to week 10 (3%), compared to 20% decrease in the CSB+IFA group and 8% decrease in the CSB+UNIMMAP group ( = 0.001). Mean serum 25-hydroxyvitamin D increased most in the RUSF group (+6.4 ng/mL), compared to CSB+IFA (+1.7 ng/mL) and CSB+UNIMMAP (+2.7 ng/mL) ( < 0.001). Micronutrient deficiencies and inflammation are common among moderately malnourished pregnant women and had little improvement despite supplementation above the RDA, with the exception of vitamins B and D.
孕期微量营养素缺乏在非洲很常见，可能导致不良后果。本研究旨在测量中度营养不良的马拉维孕妇的微量营养素状况和变化，这些孕妇在入组时（n=343）和接受以下三种营养干预 10 周后（n=229）时 MUAC≥20.6cm 且≤23.0cm：（1）即食补充食品（RUSF）；（2）添加多种微量营养素补充剂的强化玉米-大豆混合物（CSB+UNIMMAP）；或（3）添加铁和叶酸的 CSB+（CSB+IFA）。这三种干预方式都提供了 100%-300%的大多数微量营养素的推荐膳食摄入量和 900 千卡/天。在 272 名婴儿中测量了出生长度。入组时的测量结果表明，维生素 B（20.9%）和锌（22.3%）缺乏，铁蛋白（25.1%）和白蛋白（33.7%）值较低，C 反应蛋白（CRP）升高（46.0%）。已知维生素 B 在孕晚期会减少；与 CSB+IFA 组（20%）和 CSB+UNIMMAP 组（8%）相比，RUSF 组从入组到第 10 周的下降幅度最小（3%）（=0.001）。RUSF 组血清 25-羟维生素 D 的平均水平增加最多（+6.4ng/mL），与 CSB+IFA 组（+1.7ng/mL）和 CSB+UNIMMAP 组（+2.7ng/mL）相比（<0.001）。在中度营养不良的孕妇中，微量营养素缺乏和炎症很常见，尽管补充了超过 RDA 的营养素，但除了维生素 B 和 D 外，情况几乎没有改善。
