Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
World Food Programme, Islamabad, Pakistan.
Eur J Nutr. 2021 Mar;60(2):781-789. doi: 10.1007/s00394-020-02276-3. Epub 2020 May 24.
We aimed to assess the effectiveness of wheat soya blend plus (WSBP) provided during pregnancy and lactation on weight gain during pregnancy, reduction of low birthweight (LBW), and improvement in nutritional status in infants at 6 months of age in Thatta and Sujawal districts of Sindh, Pakistan.
A cluster randomized-controlled trial was conducted in Thatta and Sujawal districts in Pakistan from August 2014 to December 2016. A total of 2030 pregnant women were enrolled in the study. These women and their infants were followed during pregnancy and first 6 months of life. Pregnant women received a monthly ration of 5 kg (i.e., 165 g/day) of WSB + during pregnancy and the first 6 months of their lactation period.
There was no difference in weight gain during pregnancy between the intervention and control groups (n = 496, 326.7 g/week 95% CI 315.2-338.1 vs. (n = 507, 306.9 g/week, 95% CI 279.9-333.9 P = 0.192), after adjustment with different factors. The reduction in the prevalence of LBW was not different between intervention and control groups (n = 325, 34.0%, 95% CI 31.7-36.4, vs. (n = 127, 34.3%, 95% CI 27.2-41.5, P = 0.932). Significant reductions in risk of stunting (n = 1319 RR 0.85, 95% CI 0.73-0.99, P = 0.041), wasting (n = 1330 RR 0.77, 95% CI 0.65-0.91, P = 0.003), and underweight (n = 1295 RR 0.77, 95% CI 0.69-0.87, P < 0.001) were observed in infants at 6 months of age in the intervention as compared to the control group. However, no difference was noted on reduction in the risk of stunting among infants at 6 months of age in the intervention and control group (n = 1318 RR 0.91, 95% CI 0.78-1.07, P = 0.253) after adjustment. A significant reduction in anemia was noted (n = 1328 RR 0.94, 95% CI 0.91-0.98, P = 0.002) in infants at 6 months of age in the intervention as compared to the control group in adjusted analysis.
Provision of WSB + during pregnancy and the first 6 months of lactation is effective in reducing the risk of under nutrition and anemia in infants at 6 months of age. This study can potentially guide the government and donor agencies in investing in nutritional programmes, especially for pregnant and lactating women living in vulnerable settings.
本研究旨在评估孕期和哺乳期食用小麦大豆混合粉（WSBP）对信德省萨塔和苏贾瓦尔地区孕妇体重增加、降低低出生体重（LBW）以及改善 6 月龄婴儿营养状况的影响。
本研究于 2014 年 8 月至 2016 年 12 月在巴基斯坦萨塔和苏贾瓦尔地区进行了一项群组随机对照试验。共有 2030 名孕妇参与了该研究，在孕期和婴儿出生后 6 个月内对其进行随访。孕期和哺乳期的前 6 个月，孕妇每月可获得 5 公斤（即每天 165 克）的 WSBP。
调整了不同因素后，干预组和对照组孕妇孕期体重增加无差异（n=496，326.7g/周，95%置信区间 315.2-338.1 与（n=507，306.9g/周，95%置信区间 279.9-333.9，P=0.192）。干预组和对照组 LBW 发生率降低无差异（n=325，34.0%，95%置信区间 31.7-36.4，与（n=127，34.3%，95%置信区间 27.2-41.5，P=0.932）。与对照组相比，干预组 6 月龄婴儿发生生长迟缓（n=1319，RR 0.85，95%置信区间 0.73-0.99，P=0.041）、消瘦（n=1330，RR 0.77，95%置信区间 0.65-0.91，P=0.003）和体重不足（n=1295，RR 0.77，95%置信区间 0.69-0.87，P<0.001）的风险显著降低。然而，调整后，干预组和对照组 6 月龄婴儿生长迟缓风险降低无差异（n=1318，RR 0.91，95%置信区间 0.78-1.07，P=0.253）。与对照组相比，干预组 6 月龄婴儿贫血发生率显著降低（n=1328，RR 0.94，95%置信区间 0.91-0.98，P=0.002）。
孕期和哺乳期食用 WSBP 可有效降低 6 月龄婴儿营养不良和贫血的风险。本研究可为政府和捐赠机构投资营养项目提供参考，特别是针对生活在脆弱环境中的孕妇和哺乳期妇女。
