National Institute of Nutrition, Hanoi, Vietnam.
University of California San Francisco, San Francisco, CA, United States of America.
PLoS One. 2020 May 29;15(5):e0232197. doi: 10.1371/journal.pone.0232197. eCollection 2020.
Obtaining a nutrient-rich diet during pregnancy is a challenge for pregnant women living in low-income countries. This randomized, controlled trial was designed to determine if a freshly prepared food supplement from local animal-source foods and dark-green leafy vegetables given prior to and/or during pregnancy improved birth outcomes in rural Vietnamese women. Primiparous women, 18 to 30 years of age, who participated in the study were assigned to one of three groups: PC-T women received the supplement from pre-conception to term, MG-T women received the supplement from mid-gestation to term, and the RPC women received routine prenatal care. Supplement intake was observed and quantified. Infant anthropometry was measured at birth and/or within seven days of delivery. The effect of the intervention on maternal and birth outcomes was determined using linear regression modeling. Of the 460 women enrolled in the study, 317 women completed the study. Those not completing the study had either moved from the area, did not conceive within 12 months of study enrollment, or miscarried. The food-based supplement increased protein, iron, zinc, folate, vitamin A and B12 intakes in the PC-T and the MG-T groups. However, it failed to alter infant anthropometric measurements at birth. In the entire cohort, maternal gestational weight gain was greater in women with a low pre-pregnancy BMI (<18.5) and in women with a higher educational attainment. Working as a farmer reduced gestational weight gain but it did not affect birth weight or length. In summary, a nutrient-rich, food-based supplement given to rural Vietnamese women from pre-conception to term or mid-gestation to term did not affect maternal or infant outcomes. The low weight gains, possibly due to demanding farm work done throughout the reproductive cycle, may have obviated any effects of the low energy, nutrient-rich food supplement on birth outcomes. Trial registration : Registered Clinical Trials.gov: NCT01235767.
在低收入国家，孕妇获得营养丰富的饮食是一项挑战。本随机对照试验旨在确定在怀孕前和/或怀孕期间给予当地动物源食品和深绿色叶菜类制成的新鲜制备的食物补充剂是否能改善越南农村妇女的分娩结局。参与研究的初产妇年龄在 18 至 30 岁之间，被分配到以下三组之一：PC-T 组在受孕前至足月期间接受补充剂，MG-T 组在妊娠中期至足月期间接受补充剂，RPC 组接受常规产前护理。观察和量化补充剂的摄入量。在出生时和/或分娩后 7 天内测量婴儿的人体测量学指标。使用线性回归模型确定干预对母婴结局的影响。在 460 名参加研究的妇女中，有 317 名完成了研究。未完成研究的妇女要么已经搬离该地区，要么在研究入组后 12 个月内没有怀孕，要么流产。基于食物的补充剂增加了 PC-T 和 MG-T 组的蛋白质、铁、锌、叶酸、维生素 A 和 B12 的摄入量。然而，它未能改变出生时婴儿的人体测量学指标。在整个队列中，低孕前 BMI（<18.5）和高教育程度的妇女的母亲妊娠期体重增加更大。作为农民减少了妊娠期体重增加，但对出生体重或长度没有影响。总之，给予越南农村妇女从受孕前到足月或妊娠中期到足月的营养丰富的基于食物的补充剂并没有影响母婴结局。体重增加较低，可能是由于整个生殖周期中繁重的农场工作，可能使低能量、营养丰富的食物补充剂对分娩结局的任何影响都变得无关紧要。试验注册：ClinicalTrials.gov 注册：NCT01235767。
