Multivitamin Supplementation Is Associated with Greater Adequacy of Gestational Weight Gain among Pregnant Women in Tanzania.

Autor:	Liu E; Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA., Wang D; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA., Darling AM; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA., Perumal N; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA., Wang M; Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Biostatistics, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA., Urassa W; Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Pembe A; Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Fawzi WW; Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Nutrition, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	The Journal of nutrition [J Nutr] 2022 Apr 01; Vol. 152 (4), pp. 1091-1098.
DOI:	10.1093/jn/nxab448
Abstrakt:	Background: Gestational weight gain (GWG) is a modifiable risk factor associated with adverse birth outcomes. Studies have shown that the provision of multiple micronutrient supplements to pregnant women reduces the risk of low birth weight. However, the effect of multiple micronutrient supplements on GWG has been understudied. Objectives: We examined the effect of daily supplementation of pregnant women with multivitamins on GWG in relation to the GWG recommendation by the Institute of Medicine (IOM). Methods: Pregnant women with gestational age between 12 and 27 wk were randomly assigned to receive daily multivitamins or placebo until delivery. Weight was measured at enrollment and every follow-up visit. Percentage adequacy of GWG was calculated as actual GWG divided by the recommended GWG according to the IOM recommendation. Binary outcomes included severely inadequate (<70%), inadequate (<90%), and excessive GWG (≥125%). The analysis included 7573 women with singleton pregnancies. Multiple linear regression models were used to examine the association between multivitamin supplementation and percentage adequacy of GWG, and log-binomial models were used for binary outcomes. Results: The mean percentage adequacy of GWG was 96.7% in the multivitamin arm and 94.4% in the placebo arm, with a mean difference of 2.3% (95% CI: 0.3%, 4.2%; P = 0.022). Compared with women in the placebo arm, those who received multivitamins had a lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.97; P = 0.008) and inadequate GWG (RR: 0.95; 95% CI: 0.91, 0.99; P = 0.018). No significant difference was found in excessive GWG. Conclusions: Multivitamin supplementation increased GWG and reduced the risk of severely inadequate and inadequate GWG among pregnant women in Tanzania. Together with previously reported beneficial effects of the supplements on birth outcomes in low- and middle-income countries, our findings support scaling up the use of prenatal supplements that include multivitamins in addition to iron and folic acid.This trial was registered at clinicaltrials.gov as NCT00197548. (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)
Databáze:	MEDLINE
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