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Effect of antenatal multiple micronutrient supplementation on anthropometry and blood pressure in mid-childhood in Nepal: follow-up of a double-blind randomised controlled trial

Devakumar, D; Chaube, SS; Wells, J; Saville, NM; Ayres, JG; Manandhar, DS; Costello, A; (2014) Effect of antenatal multiple micronutrient supplementation on anthropometry and blood pressure in mid-childhood in Nepal: follow-up of a double-blind randomised controlled trial. The Lancet Global Health , 2 (11) e654-e663. 10.1016/S2214-109X(14)70314-6. Green open access

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Abstract

Background: In a randomized controlled trial in southern Nepal, we found that children born to mothers who had taken multiple micronutrient supplements during pregnancy had mean birthweight 77 g greater than a control group allocated to iron and folic acid supplements. They were a mean 204 g heavier at 2·5 years of age and their systolic blood pressure was a mean 2·5 mmHg lower. We followed the same children up in mid-childhood, hypothesizing that these differences would be sustained. Methods: We identified children from the original trial and measured anthropometry, body composition using bioelectrical impedance (with population-specific isotope calibration), blood pressure, and renal dimensions by ultrasound. We documented socieconomic status, household food security, and air pollution.Results: We assessed 841 children (422 control, 419 intervention) at mean age 8·5 years. Unadjusted differences (intervention minus control) were 0·05 z-scores (95% CI -0·09, 0·19) in weight-for-age, 0·02 z-scores (-0·10, 0·15) in height-for-age, and 0·04 z-scores (-0·09, 0·18) in body-mass-index-for-age. There was no difference in blood pressure. Adjusted differences were similar for all outcomes. Discussion: Differences in phenotype between children born to mothers who received antenatal multiple micronutrient or iron and folate supplements were not apparent at 8·5 years. Our findings did not extend to physiological differences or potential longer-term effects.

Type: Article
Title: Effect of antenatal multiple micronutrient supplementation on anthropometry and blood pressure in mid-childhood in Nepal: follow-up of a double-blind randomised controlled trial
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/S2214-109X(14)70314-6
Publisher version: http://dx.doi.org/10.1016/S2214-109X(14)70314-6
Language: English
Additional information: © Devakumar et al. Open Access article distributed under the terms of CC BY
Keywords: anthropometry, Nepal, child, micronutrients, prenatal exposure delayed effects
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Pop, Policy and Practice Prog
URI: https://discovery.ucl.ac.uk/id/eprint/1448845
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