Maternal micronutrient supplements boost baby weights

By Stephen Daniells

- Last updated on GMT

Related tags: Pregnancy, Randomized controlled trial, Infant

Supplements of micronutrients during pregnancy may result in bigger
and heavier babies, relative to babies born to mothers taking only
iron and folic acid, suggests a new study.

The research, published in this week's The Lancet​, is of particular importance since an estimated 20 million children worldwide are born with low birth weight, defined as less than 2,500 grams (5.5 pounds), with over 95 per cent these in developing countries. Low birth weight has been linked to higher risks of negative health outcomes, including neonatal and infant mortality, poor growth and cognitive development, and higher risks of chronic diseases later in life, like diabetes and heart disease. The new report, by researchers from UCL Centre for International Health and Development, Institute of Child Health (UK) and Kathmandu-based Mother and Infant Research Activities (Nepal), adds to earlier data concerning 1,200 women receiving either a multivitamin and mineral supplement or only iron and folic acid (IFA) during the second and third trimesters of pregnancy. The earlier study, published in The Lancet​ (2005, Vol. 365, pp. 955-962), reported that birth weight was, on average, 77 grams more in children born to mothers given multivitamin and mineral supplement, compared to those born to mothers given IFA. The new study followed 917 of the children from the 2005 study until the age of two and a half - 462 children were from mothers given multivitamin and mineral supplement and 455 from mothers in the IFA group. Lead researcher David Osrin and co-workers report that children were an average of 204 grams heavier if their mothers had received the multivitamin and mineral supplement, compared to those born to mothers given IFA - 10.9 versus 10.7 kg, respectively. Furthermore, the heavier children were also bigger, with a 2.4 mm bigger head circumference, a 3.2 mm bigger chest circumference, and a 2.4 mm bigger mid-upper arm circumference. The systolic blood pressure was also a mean of 2.5 mm Hg lower in the children born to mothers given multivitamin and mineral supplement, wrote the researchers. "In a poor population, the effects of maternal multiple micronutrient supplementation on the foetus persisted into childhood, with increases in both weight and body size,"​ they wrote. "These increases were small, however, since those exposed to micronutrients had an average of 2 per cent higher weight than controls. The public-health implications of changes in weight and blood pressure need to be clarified through follow-up." ​ In an accompanying editorial, Keith West and Parul Christian from the Johns Hopkins University Bloomberg School of Public Healthsaid: "At present, the clearest lesson from the study by Osrin and colleagues lies in the example it sets for successful follow-up of randomised trial cohorts of children that can reveal latent causal effects of antenatal micronutrient supplementation on growth and chronic-disease risk in undernourished populations." ​ The study is in-line with a report published last year in the Archives of Pediatrics & Adolescent Medicine​ (Vol. 161, pp. 58-64). Researchers from University College of Medical Sciences, Delhi conducted a randomised trial involving 200 women and report that babies of mothers from the micronutrient group weighed an average of 98 grams more and were 0.8 centimetres longer. Low birth weight was recorded in only 15.2 per cent of the babies from mothers in the micronutrient supplement group, compared to 43.1 per cent in the placebo group. Source: The Lancet​ 2008, Volume 371, Pages 492-499 "Effects of antenatal multiple micronutrient supplementation on children's weight and size at 2 years of age in Nepal: follow-up of a double-blind randomised controlled trial" ​Authors: A. Vaidya, N. Saville, B.P. Shrestha, A.M. de L Costello, D.S. Manandhar, D. Osrin Editorial: The Lancet​ 2008, Volume 371, Pages 452-454 "Antenatal micronutrients in undernourished people" ​Authors: K. West and P. Christian

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