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Randomized Controlled Trial
. 2018 Oct;14(4):e12640.
doi: 10.1111/mcn.12640. Epub 2018 Jul 26.

Effects of lipid-based nutrient supplements or multiple micronutrient supplements compared with iron and folic acid supplements during pregnancy on maternal haemoglobin and iron status

Josh M Jorgensen  1 , Per Ashorn  2   3 , Ulla Ashorn  4 , Lacey M Baldiviez  1 , Austrida Gondwe  5 , Ken Maleta  5 , Minyanga Nkhoma  5 , Kathryn G Dewey  1
Affiliations
Randomized Controlled Trial

Effects of lipid-based nutrient supplements or multiple micronutrient supplements compared with iron and folic acid supplements during pregnancy on maternal haemoglobin and iron status

Josh M Jorgensen et al. Matern Child Nutr. 2018 Oct.

Abstract

We examined the effect of three types of prenatal supplements containing different amounts of iron on haemoglobin (Hb) and iron status (zinc protoporphyrin [ZPP] and soluble transferrin receptor [sTfR]) in late pregnancy among 1,379 women in rural Malawi. Participants were recruited at ≤20 gestational weeks (gw) and randomly assigned to consume daily (1) 60-mg iron and folic acid (IFA); (2) 20-mg iron plus 17 micronutrients in a capsule (MMN); or (3) lipid-based nutrient supplement (LNS; 118 kcal) with 20-mg iron plus 21 micronutrients, protein, and fat. We analysed differences between intervention groups in mean Hb, ZPP, and sTfR at 36 gw, and the proportion with anaemia (Hb < 100 g L-1 ) and iron deficiency (ZPP > 60 μmol mol-1 haem or sTfR > 6 mg L-1 ) at 36 gw. Women in the IFA group had higher Hb at 36 gw than women in the LNS group (P = 0.030) and higher iron status (lower ZPP and sTfR) than women in both the LNS (P < 0.001 for both ZPP and sTfR) and MMN (P = 0.025 and P = 0.046) groups. Results for anaemia and iron deficiency showed similar trends. Further research is needed to elucidate the appropriate amount of iron to improve Hb and iron status, while improving birth outcomes.

Keywords: haemoglobin; iron; lipid-based nutrient supplement; multiple micronutrient; pregnancy.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic representation of recruitment, enrolment, and follow‐up of Malawian women who participated in the iLiNS Project. IFA: iron–folic acid; MMN: multiple micronutrient; Hb: haemoglobin; ZPP: zinc protoporphyrin; sTfR: soluble transferrin receptor
See this image and copyright information in PMC

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