National Institute of Nutrition, Hanoi, Vietnam.
University of California San Francisco, San Francisco, California, United States of America.
PLoS One. 2020 Jun 25;15(6):e0233671. doi: 10.1371/journal.pone.0233671. eCollection 2020.
Growth faltering among children during the first five years of life is a common problem among low and middle-income countries. The purpose of this study was to determine the effect of a nutrient-rich, food-based supplement given to Vietnamese rural women prior to and/or during pregnancy on the growth of their infants during first 24 months of life and to identify maternal and newborn factors associated with the infant's growth. This prospective cohort study included 236 infants born to mothers who had received nutritional advice or a food supplement from pre-conception to term or from mid-gestation to term as part of a prior randomized controlled trial. Infant anthropometry and feeding information were monitored monthly and the infant weight for age Z-score (WAZ), length for age Z-score (LAZ), and weight for length Z-score (WLZ) were assessed at 6, 12, 18, and 24 months of age using mixed-effects regression modeling. Compared to the non-supplemented mothers, infants born to mothers receiving food supplementation from mid-gestation to term had significantly higher WLZ only at 18 months (p = 0.03) and did not differ in other outcomes. Supplementation from pre-conception to term did not affect infant growth at any time point during the first 24 months. In the entire study cohort, maternal height and gestational weight gain were positively associated with the infant's WAZ and LAZ from 6 to 24 months of age. Programs designed to improve gestational weight gain among women performing demanding physical work throughout a reproductive cycle may improve postnatal infant growth. Trial registration: Registered Clinical Trials.Gov: NCT01235767.
在生命的头五年中,儿童生长迟缓是中低收入国家的一个常见问题。本研究旨在确定在怀孕前和/或怀孕期间向越南农村妇女提供营养丰富的基于食物的补充剂对其婴儿在生命头 24 个月的生长的影响,并确定与婴儿生长相关的产妇和新生儿因素。这项前瞻性队列研究包括 236 名婴儿,他们的母亲在受孕前至足月或从中孕期至足月期间接受了营养咨询或食物补充,作为先前随机对照试验的一部分。每月监测婴儿的人体测量和喂养信息,并在 6、12、18 和 24 个月时使用混合效应回归模型评估婴儿的体重年龄 Z 评分(WAZ)、年龄长度 Z 评分(LAZ)和体重长度 Z 评分(WLZ)。与未接受补充的母亲相比,从中孕期至足月接受食物补充的母亲所生的婴儿仅在 18 个月时 WLZ 显著更高(p = 0.03),而在其他结果方面没有差异。从受孕前至足月的补充在生命的头 24 个月的任何时间点都没有影响婴儿的生长。在整个研究队列中,母亲的身高和孕期体重增加与婴儿从 6 至 24 个月的 WAZ 和 LAZ 呈正相关。在整个生殖周期中从事繁重体力劳动的女性中,旨在改善孕期体重增加的计划可能会改善产后婴儿的生长。试验注册:注册临床Trials.gov:NCT01235767。