EFFECT OF LIPID-BASED NUTRITIONAL SUPPLEMENTS DURING PREGNANCY ON MATERNAL ANTHROPOMETRY AND HEMATOLOGICAL INDICES; A RANDOMIZED CONTROLLED TRIAL
DOI:
https://doi.org/10.70520/kjms.v18i3.751Keywords:
Gravida, Supplement, Lipid based nutritional supplements, BMIAbstract
Objective: To investigate the effect of using lipid based supplements during pregnancy on body composition, BMI and hematological profile.
Material & Methods: A randomized controlled trial was undertaken from 2018 to 2019 to find out the effect of LNS(MAAMTA) on body composition, BMI and hematological findings. Forty underweight primigravidas from different tertiary care hospitals of KPK were randomized into two groups of; Supplement: receiving MAAMTA plus antenatal treatment and Placebo: receiving placebo plus antenatal treatment. They continued taking these (MAAMTA/Placebo) from first antenatal visit till one week postnatal. Fasting blood samples were collected and anthropometric measurements taken at three different time points i.e; baseline visit, 16 weeks of gestation and post natal visit
Results: The analysis of variance (ANOVA) indicated a statistically significant influence of time on the BMI of participants, with results showing F(2, 68) = 44.8, P < 0.01, and a partial eta squared (?p²) of 0.57. In a similar manner, time had a strong effect on participants’ body weight, F(2, 68) = 36.32, P < 0.01, ?p² = 0.51. Furthermore, the intervention group demonstrated a significant within-group effect of supplementation on weight, F(2, 68) = 3.18, P = 0.048, ?p² = 0.086. For body mass, the within-group analysis revealed a notable effect of supplementation, F(1.37, 46.7) = 3.63, P = 0.050, ?p² = 0.096. A highly significant effect of time on mid-upper arm circumference (MUAC) was also evident, F(2, 68) = 9.70, P < 0.001, ?p² = 0.222. However, no notable impact was seen in case of hematological profile.
Conclusion: The study revealed a statistically strong association of time with BMI, weight, and MUAC, indicating improvement in anthropometric measures.
References
1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.
2. Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371(9610):417–40.
3. Dewey KG, Adu?Afarwuah S. Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Matern Child Nutr. 2008;4:24–85.
4. Ahmed AAH. Sociodemographic and prenatal predictors of preterm birth, low birth weight and caesarean section and the impact on child feeding practices, perinatal and early years health. University of Sunderland; 2021.
5. Shaikh S, Mir AM. A systematic review of the treatment and management of pre-eclampsia and eclampsia in Pakistan. 2016;
6. Dewey KG, Matias SL, Mridha MK, Arnold CD. Nutrient supplementation during the first 1000 days and growth of infants born to pregnant adolescents. Ann N Y Acad Sci. 2020;1468(1):25–34.
7. Brenna JT, Lapillonne A. Background paper on fat and fatty acid requirements during pregnancy and lactation. Ann Nutr Metab. 2009;55(1/3):97–122.
8. Sher N, Mubaraki MA, Zafar H, Nazli R, Zafar M, Fatima S, et al. Effect of lipid-based multiple micronutrients supplementation in underweight primigravida pre-eclamptic women on maternal and pregnancy outcomes: randomized clinical trial. Medicina (B Aires). 2022;58(12):1772.
9. Deputy NP, Sharma AJ, Kim SY. Gestational weight gain—United States, 2012 and 2013. MMWR Morb Mortal Wkly Rep. 2015;64(43):1215–20.
10. Power ML, Schulkin J. Obstetrician/gynecologists’ knowledge, attitudes, and practices regarding weight gain during pregnancy. J Women’s Heal. 2017;26(11):1169–75.
11. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. Bmj. 2013;346.
12. Kaestel P, Michaelsen KF, Aaby P, Friis H. Effects of prenatal multimicronutrient supplements on birth weight and perinatal mortality: a randomised, controlled trial in Guinea-Bissau. Eur J Clin Nutr. 2005;59(9):1081–9.
13. Matias SL, Mridha MK, Paul RR, Hussain S, Vosti SA, Arnold CD, et al. Prenatal lipid-based nutrient supplements affect maternal anthropometric indicators only in certain subgroups of rural Bangladeshi women. J Nutr. 2016;146(9):1775–82.
14. Changamire FT, Mwiru RS, Peterson KE, Msamanga GI, Spiegelman D, Petraro P, et al. Effect of multivitamin supplements on weight gain during pregnancy among HIV?negative women in T anzania. Matern Child Nutr. 2015;11(3):297–304.
15. Smith ER, Shankar AH, Wu LSF, Aboud S, Adu-Afarwuah S, Ali H, et al. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries. Lancet Glob Heal. 2017;5(11):e1090–100.
16. De?Regil LM, Suchdev PS, Vist GE, Walleser S, Peña?Rosas JP. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age. Evidence?Based Child Heal A Cochrane Rev J. 2013;8(1):112–201.
17. Mridha MK, Matias SL, Chaparro CM, Paul RR, Hussain S, Vosti SA, et al. Lipid-based nutrient supplements for pregnant women reduce newborn stunting in a cluster-randomized controlled effectiveness trial in Bangladesh. Am J Clin Nutr. 2016;103(1):236–49.
18. Tariq K, Fatima S, Nazli R, Habib SH, Shah M. Impact of Lipid-Based Nutritional Supplementation in Primi-Gravidas and Its Effect on Maternal, Birth and Infant Outcomes: a randomized controlled trial. Khyber Med Univ J. 2021;13(4):187–92.
19. Matias SL, Mridha MK, Paul RR, Hussain S, Vosti SA, Arnold CD, et al. Prenatal Lipid-Based Nutrient Supplements Affect Maternal Anthropometric Indicators Only in Certain Subgroups of Rural Bangladeshi. 2016;
20. Mastiholi SC, Somannavar MS, Vernekar SS, Kumar SY, Dhaded SM, Herekar VR, et al. Food insecurity and nutritional status of preconception women in a rural population of North Karnataka, India. Reprod Health. 2018;15(1):101–7.
21. Darnton-Hill I, Mkparu UC. Micronutrients in pregnancy in low-and middle-income countries. Nutrients. 2015;7(3):1744–68.
22. Kumar P, Dhillon P. Structural equation modeling on the relationship between maternal characteristics and pregnancy complications: A study based on National Family Health Survey. J Obstet Gynaecol Res. 2021;47(2):592–605.
