Document Type
Article
Publication Date
7-6-2022
Abstract
BACKGROUND: The multicountry Women First trial demonstrated that nutritional supplementation initiated prior to conception (arm 1) or early pregnancy (arm 2) and continued until delivery resulted in significantly greater length at birth and 6 mo compared with infants in the control arm (arm 3).
OBJECTIVES: We evaluated intervention effects on infants' longitudinal growth trajectory from birth through 24 mo and identified predictors of length status and stunting at 24 mo.
METHODS: Infants' anthropometry was obtained at 6, 12, 18, and 24 mo after the Women First trial (registered at clinicaltrials.gov as NCT01883193), which was conducted in low-resource settings: Democratic Republic of Congo, Guatemala, India, and Pakistan. Longitudinal models evaluated intervention effects on infants' growth trajectory from birth to 24 mo, with additional modeling used to identify adjusted predictors for growth trajectories and outcomes at 24 mo.
RESULTS: Data for 2337 (95% of original live births) infants were evaluated. At 24 mo, stunting rates were 62.8%, 64.8%, and 66.3% for arms 1, 2, and 3, respectively (NS). For the length-for-age z-score (LAZ) trajectory, treatment arm was a significant predictor, with adjusted mean differences of 0.19 SD (95% CI: 0.08, 0.30; P < 0.001) and 0.17 SD (95% CI: 0.07, 0.27; P < 0.001) for arms 1 and 2, respectively. The strongest predictors of LAZ at 24 mo were birth LAZ
CONCLUSIONS: Substantial improvements in postnatal growth are likely to depend on improved intrauterine growth, especially during early pregnancy.
Recommended Citation
Krebs, Nancy F; Hambidge, K Michael; Westcott, Jamie L; Garcés, Ana L; Figueroa, Lester; Tshefu, Antoinette K; Lokangaka, Adrien L; Goudar, Shivaprasad S; Dhaded, Sangappa M; Saleem, Sarah; Ali, Sumera Aziz; Bauserman, Melissa S; Derman, Richard J; Goldenberg, Robert L; Das, Abhik; and Chowdhury, Dhuly, "Birth length Is the Strongest Predictor of Linear Growth Status and Stunting in the First 2 Years of Life after a Preconception Maternal Nutrition Intervention: the Children of the Women First Trial" (2022). Department of Obstetrics and Gynecology Faculty Papers. Paper 86.
https://jdc.jefferson.edu/obgynfp/86
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
35681255
Language
English
Comments
This article is the author's final published version in American Journal of Clinical Nutrition, Volume 116, Issue 1, July 2022, Pages 86 - 96.
The published version is available at https://doi.org/10.1093/ajcn/nqac051.
Copyright © The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.