SEARCHRCTobstetrics and gynecology, clinical nutrition

RCT·obstetrics and gynecology, clinical nutrition, micronutrients, pediatrics, clinical trial·PMC10406330

Effect of prenatal micronutrient-fortified balanced energy-protein supplementation on maternal and newborn body composition: A sub-study from the MISAME-III randomized controlled efficacy trial in rural Burkina Faso

PLOS Medicine · 14 authors, 4 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

This randomized controlled trial sub-study evaluated prenatal supplementation with micronutrient-fortified balanced energy-protein (BEP) in pregnant women in Burkina Faso. The central result was that BEP supplementation significantly increased the fat-free mass index (FFMI) in both mothers and their newborns, with no significant effect on fat-mass index (FMI).

Full summary

954 CHARS

Pregnant women (n=1,897) were randomized to receive micronutrient-fortified BEP plus IFA or IFA alone. Body composition of a subset of mothers (intervention n=186, control n=185) and newborns (intervention n=352, control n=368) was assessed postpartum using deuterium dilution. The analysis followed a modified intention-to-treat approach. Results showed prenatal BEP supplementation led to a significantly higher FFMI in mothers (mean difference: 0.45; 95% CI: 0.05, 0.84; P = 0.026) and newborns (mean difference: 0.28; 95% CI: 0.06, 0.50; P = 0.012). There were no statistically significant effects on FMI. The effect on maternal FFMI was greater in mothers from food-secure households and with better nutritional status. Limitations include a high degree of missing data (~18%), lack of baseline body composition, and no long-term follow-up. The findings suggest BEP supplementation increases fat-free mass accretion without causing excess adiposity.

STUDY TYPE

RCT

SPECIALTY

obstetrics and gynecology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10406330

Effect of prenatal micronutrient-fortified balanced energy-protein supplementation on maternal and newborn body composition: A sub-study from the MISAME-III randomized controlled efficacy trial in rural Burkina Faso

PLOS Medicine

READ THE FULL PAPER

ABSTRACT

Background Micronutrient-fortified balanced energy-protein (BEP) supplements are promising interventions to prevent intrauterine growth retardation in low- and middle-income countries. On the other hand, one concern with blanket prenatal supplementation programs using energy-dense supplements is that they could lead to more maternal and/or infant overweight. However, evidence is lacking on the potential effect of BEP on maternal and offspring body composition. This study evaluates the effects of micronutrient-fortified BEP supplementation during pregnancy on body composition of mothers and their newborns in rural Burkina Faso. Methods and findings The MISAME-III study is an open label individually randomized controlled trial where pregnant women ( n = 1,897) of gestational age <21 weeks received either a combination of micronutrient-fortified BEP and iron-folic acid (IFA) tablets (i.e., intervention) or IFA alone (i.e., control). The prenatal phase of the MISAME-III study was conducted between the first enrollment in October 2019 and the last delivery in August 2021. In a sub-study nested under the MISAME-III trial, we evaluated anthropometry and body composition in newborns who were born starting from 17 November 2020 ( n : control = 368 and intervention = 352) and their mothers ( n : control = 185 and intervention = 186). Primary study outcomes were newborn and maternal fat-free mass (FFMI) and fat-mass (FMI) indices. We used the deuterium dilution method to determine FFMI and FMI and %FFM and %FM of total body weight within 1 month postpartum. Our main analysis followed a modified intention-to-treat approach by analyzing all subjects with body composition data available. Univariable and multivariable linear regression models were fitted to compare the intervention and control arms, with adjusted models included baseline maternal age, height, arm fat index, hemoglobin concentration and primiparity, household size, wealth and food security indices, and newborn age (days). At study enrollment, the mean ± SD maternal age was 24.8 ± 6.13 years and body mass index (BMI) was 22.1 ± 3.02 kg/m 2 with 7.05% of the mothers were underweight and 11.5% were overweight. Prenatal micronutrient-fortified BEP supplementation resulted in a significantly higher FFMI in mothers (MD (mean difference): 0.45; 95% CI (confidence interval): 0.05, 0.84; P = 0.026) and newborns (MD: 0.28; 95% CI: 0.06, 0.50; P = 0.012), whereas no statistically significant effects were found on FMI. The effect of micronutrient-fortified BEP on maternal FFMI was greater among mothers from food secure households and among those with a better nutritional status (BMI ≥21.0 kg/m 2 or mid-upper arm circumference (MUAC) ≥23 cm). Key limitations of the study are the relatively high degree of missing data (approximately 18%), the lack of baseline maternal body composition values, and the lack of follow-up body composition measurements to evaluate any long-term effects. Conclusions Micronutrient-fortified BEP supplementation during pregnancy can increase maternal and newborn FFMI, without significant effects on FMI. Trial registration ClinicalTrials.gov with identifier NCT03533712 .

CITATION EXPORT

Alemayehu Argaw, Laeticia Celine Toe, Giles Hanley-Cook et al.. Effect of prenatal micronutrient-fortified balanced energy-protein supplementation on maternal and newborn body composition: A sub-study from the MISAME-III randomized controlled efficacy trial in rural Burkina Faso. PLOS Medicine. (2023). https://doi.org/10.1371/journal.pmed.1004242

AUTHORS

14 · 4 CENTRES

Alemayehu Argaw, Laeticia Celine Toe, Giles Hanley-Cook, Trenton Dailey-Chwalibóg, Brenda de Kok, Lionel Ouédraogo, Anderson Compaoré, Moctar Ouédraogo, Amadi Sawadogo, Rasmané Ganaba, Katrien Vanslambrouck, Patrick Kolsteren, Carl Lachat, Lieven Huybregts

1 Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
2 Unité Nutrition et Maladies Métaboliques, Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
3 AFRICSanté, Bobo-Dioulasso, Burkina Faso
4 Poverty, Health, and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, United States of America