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.
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.
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DOI：
10.1016/s2214-109x(14)70314-6
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发表时间：
2014-11
影响因子：
34.3
通讯作者：
Osrin, David
中科院分区：
文献类型：
--
作者：
Devakumar, Delan;Chaube, Shiva Shankar;Wells, Jonathan C. K.;Saville, Naomi M.;Ayres, Jon G.;Manandhar, Dharma S.;Costello, Anthony;Osrin, David
在2002-04年，我们在尼泊尔南部进行了一项随机对照试验，并报告说，在怀孕期间服用多种微量营养素补充剂的母亲所生的孩子的平均出生体重比服用铁和叶酸补充剂的母亲所生的孩子高77 g。研究组母亲所生的孩子在2.5岁时平均重204 g，他们的收缩压平均比对照组母亲所生的孩子低2.5 mm Hg。我们的目的是随访相同的儿童到儿童中期（8岁半），以调查这些差异是否会持续下去。在这项后续研究中，我们从原始试验中识别了儿童，并通过超声测量了人体测量、生物电阻抗身体成分（具有特定人群的同位素校准）、血压和肾脏尺寸。我们记录了社会经济状况、家庭粮食安全和空气污染。8年随访的主要结果是根据WHO儿童生长标准（5-19岁儿童）的年龄别体重、年龄别身高和年龄别体重指数（BMI）的Z评分和血压。本研究已在国际标准随机对照试验注册中心注册，注册号为ISRCTN 88625934。2011年9月21日至2012年12月7日期间，我们评估了841名儿童（对照组422名，干预组419名）。年龄别体重Z评分的未校正差异（干预组减去对照组）为0.05（95%CI-0.09至0.19），年龄别身高为0.02（-0.10至0.15），年龄别BMI为0.04（-0.09至0.18）。我们没有记录到血压的差异。所有结局的调整后差异相似。我们记录到，在8岁半时接受产前多种微量营养素或铁和叶酸补充剂的母亲所生的孩子在表型上没有差异。我们的发现并没有延伸到生理差异或潜在的长期影响。Wellcome Trust。
In 2002–04, we did a randomised controlled trial in southern Nepal, and reported that children born to mothers taking multiple micronutrient supplements during pregnancy had a mean birthweight 77 g greater than children born to mothers taking iron and folic acid supplements. Children born to mothers in the study group were a mean 204 g heavier at 2·5 years of age and their systolic blood pressure was a mean 2·5 mm Hg lower than children born to mothers in the control group. We aimed to follow up the same children to mid-childhood (age 8·5 years) to investigate whether these differences would be sustained. For this follow-up study, we identified children from the original trial and measured anthropometry, body composition with bioelectrical impedance (with population-specific isotope calibration), blood pressure, and renal dimensions by ultrasound. We documented socioeconomic status, household food security, and air pollution. Main outcomes of the follow-up at 8 years were Z scores for weight-for-age, height-for-age, and body-mass index (BMI)-for-age according to WHO Child Growth Standards for children aged 5–19 years, and blood pressure. This study is registered with the International Standard Randomised Controlled Trial register, number ISRCTN88625934. Between Sept 21, 2011, and Dec 7, 2012, we assessed 841 children (422 in the control group and 419 in the intervention group). Unadjusted differences (intervention minus control) in Z scores were 0·05 for weight-for-age (95% CI −0·09 to 0·19), 0·02 in height-for-age (−0·10 to 0·15), and 0·04 in BMI-for-age (−0·09 to 0·18). We recorded no difference in blood pressure. Adjusted differences were similar for all outcomes. We recorded no differences in phenotype between children born to mothers who received antenatal multiple micronutrient or iron and folate supplements at age 8·5 years. Our findings did not extend to physiological differences or potential longer-term effects. The Wellcome Trust.