Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Kaifu District, Changsha 410078, Hunan, China.
Int J Environ Res Public Health. 2019 Aug 1;16(15):2744. doi: 10.3390/ijerph16152744.
At present, there is insufficient evidence on whether prenatal multi-micronutrient (MM) supplementation can be an antenatal nutritional intervention or not. This study aimed to explore the sustained effect of prenatal MM supplementation on early childhood health. A total of 939 mother-offspring pairs were followed up in the study between 2015 to 2018 in Changsha, China. Information was mainly collected through household surveys at the ages of 1, 3, 6, 8, 12, 18, 24, and 36 months. General linear models and generalized estimating equation models were used to estimate the effects of maternal prenatal MM compared with IFA supplementation on infant growth and development. Offspring of women who used prenatal MM compared with IFA supplements had lower weight-for-age z score (WAZ) (adjusted β: -0.23, 95% CI: (-0.40, -0.06)) and weight-for-length z score (WLZ) (adjusted β: -0.20, 95% CI: (-0.37, -0.02)) at 3 months old, but a reduced risk of obesity at birth (aRR: 0.30, 95% CI: 0.11-0.78) and being overweight at 3 months old (aRR: 0.52, 95% CI: 0.32-0.84). Moreover, offspring of women who used prenatal MM compared with IFA supplements had significantly higher scores for communication (adjusted β: 0.41, 95% CI: 0.61-0.21), gross motor (adjusted β: 0.68, 95% CI: 0.49-0.88), fine motor (adjusted β: 1.64, 95% CI: 1.45-1.84), problem solving (adjusted β: 0.29, 95% CI: 0.10-0.49), and personal-social (adjusted β: 0.90, 95% CI: 0.70-1.10) skills at 36 months old. Prenatal MM supplementation could result in better infant growth in the first few months of life and improve development scores at the age of 3 years compared with IFA supplementation.
目前,关于产前多种微量营养素(MM)补充是否可以作为产前营养干预措施,证据还不够充分。本研究旨在探索产前 MM 补充对儿童早期健康的持续影响。2015 年至 2018 年,在中国长沙共对 939 对母婴进行了随访。主要通过在 1、3、6、8、12、18、24 和 36 个月龄时的家庭调查收集信息。采用一般线性模型和广义估计方程模型,估计母亲产前 MM 与 IFA 补充剂对婴儿生长发育的影响。与使用 IFA 补充剂的女性所生的后代相比,使用产前 MM 补充剂的女性的婴儿体重年龄 Z 评分(WAZ)(调整后β:-0.23,95%置信区间:-0.40,-0.06)和体重长度 Z 评分(WLZ)(调整后β:-0.20,95%置信区间:-0.37,-0.02)在 3 个月时较低,但出生时肥胖的风险降低(aRR:0.30,95%置信区间:0.11-0.78)和 3 个月时超重(aRR:0.52,95%置信区间:0.32-0.84)。此外,与使用 IFA 补充剂的女性所生的后代相比,使用产前 MM 补充剂的女性的后代在交流(调整后β:0.41,95%置信区间:0.61-0.21)、粗大运动(调整后β:0.68,95%置信区间:0.49-0.88)、精细运动(调整后β:1.64,95%置信区间:1.45-1.84)、解决问题(调整后β:0.29,95%置信区间:0.10-0.49)和个人社交(调整后β:0.90,95%置信区间:0.70-1.10)技能方面得分更高,在 36 个月龄时。与 IFA 补充相比,产前 MM 补充可在生命最初几个月内使婴儿生长更好,并在 3 岁时提高发育评分。