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Randomized Controlled Trial
. 2022 Dec 13;51(6):1761-1774.
doi: 10.1093/ije/dyab117.

Effects of prenatal and postnatal maternal multiple micronutrient supplementation on child growth and morbidity in Tanzania: a double-blind, randomized-controlled trial

Dongqing Wang  1 , Uma Chandra Mouli Natchu  2 , Anne Marie Darling  1 , Ramadhani A Noor  3 , Ellen Hertzmark  1 , Willy Urassa  4 , Wafaie W Fawzi  1   5   6
Affiliations
Randomized Controlled Trial

Effects of prenatal and postnatal maternal multiple micronutrient supplementation on child growth and morbidity in Tanzania: a double-blind, randomized-controlled trial

Dongqing Wang et al. Int J Epidemiol. .

Abstract

Background: Maternal micronutrient status is critical for child growth and nutrition. It is unclear whether maternal multiple micronutrient supplementation (MMS) during pregnancy and lactation improves child growth and prevents child morbidity.

Methods: This study aimed to determine the effects of prenatal and postnatal maternal MMS on child growth and morbidity. In this double-blind, randomized-controlled trial, 8428 HIV-negative pregnant women were enrolled from Dar es Salaam, Tanzania, between 2001 and 2004. From pregnancy (12-27 weeks of gestation) through to 6 weeks postpartum, participants were randomized to receive daily oral MMS or placebo. All women received daily iron and folic acid during pregnancy. From 6 weeks postpartum through to 18 months postpartum, 3100 women were re-randomized to MMS or placebo. Child-growth measures, haemoglobin concentrations and infectious morbidities were assessed longitudinally from birth to ≤18 months.

Results: Prenatal MMS led to modest increases in weight-for-age z-scores (mean difference: 0.050; 95% confidence interval: 0.002, 0.099; p = 0.04) and length-for-age z-score (mean difference: 0.062; 95% confidence interval: 0.013, 0.111; p = 0.01) during the first 6 months of life but not thereafter. Prenatal or postnatal MMS did not have benefits for other child outcomes.

Conclusions: Whereas maternal MMS is a proven strategy to prevent adverse birth outcomes, other approaches may also need to be considered to curb the high burdens of child morbidity and growth faltering.

Trial registration: ClinicalTrials.gov NCT00197548.

Keywords: Pregnancy; Tanzania; anaemia; lactation; micronutrients; postpartum; supplementation; vitamin; women.

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Figures

Figure 1
Figure 1
Study profile of a randomized–controlled trial of prenatal and postnatal maternal multiple micronutrient supplementation on child growth and morbidity among HIV-negative women in Dar es Salaam, Tanzania (2001–2006). MMS, multiple micronutrient supplementation.
See this image and copyright information in PMC

References

    1. Ministry of Health CD, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], Tanzania Food and Nutrition Centre (TFNC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS) [Zanzibar] and UNICEF. Tanzania National Nutrition Survey using SMART Methodology (TNNS) 2018. Dar es Salaam, Tanzania: MoHCDGEC, MoH, TFNC, NBS, OCGS, and UNICEF, 2018.
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    1. World Health Organization. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Geneva: World Health Organization, 2016. - PubMed
    1. World Health Organization. WHO Recommendations on Postnatal Care of the Mother and Newborn. Geneva: World Health Organization, 2014. - PubMed

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