Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal
- PMID: 16600929
- DOI: 10.1093/ajcn/83.4.788
Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal
Abstract
Background: Previously we showed that women in rural Nepal experience multiple micronutrient deficiencies in early pregnancy.
Objective: This study examined the effects of daily antenatal micronutrient supplementation on changes in the biochemical status of several micronutrients during pregnancy.
Design: In Nepal, we conducted a randomized controlled trial in which 4 combinations of micronutrients (folic acid, folic acid + iron, folic acid + iron + zinc, and a multiple micronutrient supplement containing folic acid, iron, zinc, and 11 other nutrients) plus vitamin A, or vitamin A alone as a control, were given daily during pregnancy. In a subsample of subjects (n = 740), blood was collected both before supplementation and at approximately 32 wk of gestation.
Results: In the control group, serum concentrations of zinc, riboflavin, and vitamins B-12 and B-6 decreased, whereas those of copper and alpha-tocopherol increased, from the first to the third trimester. Concentrations of serum folate, 25-hydroxyvitamin D, and undercarboxylated prothrombin remained unchanged. Supplementation with folic acid alone or folic acid + iron decreased folate deficiency. However, the addition of zinc failed to increase serum folate, which suggests a negative inhibition; multiple micronutrient supplementation increased serum folate. Folic acid + iron + zinc failed to improve zinc status but reduced subclinical infection. Multiple micronutrient supplementation decreased the prevalence of serum riboflavin, vitamin B-6, vitamin B-12, folate, and vitamin D deficiencies but had no effect on infection.
Conclusions: In rural Nepal, antenatal supplementation with multiple micronutrients can ameliorate, to some extent, the burden of deficiency. The implications of such biochemical improvements in the absence of functional and health benefits remain unclear.
Similar articles
-
Antenatal Multiple Micronutrient Supplementation Compared to Iron-Folic Acid Affects Micronutrient Status but Does Not Eliminate Deficiencies in a Randomized Controlled Trial Among Pregnant Women of Rural Bangladesh.J Nutr. 2019 Jul 1;149(7):1260-1270. doi: 10.1093/jn/nxz046. J Nutr. 2019. PMID: 31006806 Free PMC article. Clinical Trial.
-
Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal.JAMA. 2010 Dec 22;304(24):2716-23. doi: 10.1001/jama.2010.1861. JAMA. 2010. PMID: 21177506 Clinical Trial.
-
The effect of maternal micronutrient supplementation on early neonatal morbidity in rural Nepal: a randomised, controlled, community trial.Arch Dis Child. 2008 Aug;93(8):660-4. doi: 10.1136/adc.2006.114009. Arch Dis Child. 2008. PMID: 18644934 Clinical Trial.
-
Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana.Indian J Pediatr. 2004 Nov;71(11):1007-14. doi: 10.1007/BF02828117. Indian J Pediatr. 2004. PMID: 15572822 Review.
-
Micronutrient supplementation in adults with HIV infection.Cochrane Database Syst Rev. 2017 May 18;5(5):CD003650. doi: 10.1002/14651858.CD003650.pub4. Cochrane Database Syst Rev. 2017. PMID: 28518221 Free PMC article. Review.
Cited by
-
Folic acid: The key to a healthy pregnancy - A prospective study on fetomaternal outcome.Tzu Chi Med J. 2023 Oct 31;36(1):98-102. doi: 10.4103/tcmj.tcmj_110_23. eCollection 2024 Jan-Mar. Tzu Chi Med J. 2023. PMID: 38406574 Free PMC article.
-
Maternal prenatal, with or without postpartum, vitamin D3 supplementation does not improve maternal iron status at delivery or infant iron status at 6 months of age: secondary analysis of a randomised controlled trial.BMJ Nutr Prev Health. 2023 Dec;6(2):282-292. doi: 10.1136/bmjnph-2023-000758. Epub 2023 Nov 14. BMJ Nutr Prev Health. 2023. PMID: 38264359 Free PMC article.
-
Effects of vitamin and mineral supplementation during pregnancy on maternal, birth, child health and development outcomes in low- and middle-income countries: A systematic review.Campbell Syst Rev. 2021 Jun 26;17(2):e1127. doi: 10.1002/cl2.1127. eCollection 2021 Jun. Campbell Syst Rev. 2021. PMID: 37051178 Free PMC article.
-
Pregnancy Interventions to Improve Birth Outcomes: What Are the Effects on Maternal Outcomes? A Scoping Review.Int J Public Health. 2022 Nov 2;67:1604620. doi: 10.3389/ijph.2022.1604620. eCollection 2022. Int J Public Health. 2022. PMID: 36405527 Free PMC article. Review.
-
Prenatal supplementation with multiple micronutrient supplements or medium-quantity lipid-based nutrient supplements has limited effects on child growth up to 24 months in rural Niger: a secondary analysis of a cluster randomized trial.Am J Clin Nutr. 2022 Mar 4;115(3):738-748. doi: 10.1093/ajcn/nqab404. Am J Clin Nutr. 2022. PMID: 34871344 Free PMC article. Clinical Trial.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources