Growth from Birth through Six Months for Infants of Mothers in the "Women First" Preconception Maternal Nutrition Trial

Nancy F Krebs, K Michael Hambidge, Jamie L Westcott, Ana L Garcés, Lester Figueroa, Antoinette K Tsefu, Adrien L Lokangaka, Shivaprasad S Goudar, Sangappa M Dhaded, Sarah Saleem, Sumera Aziz Ali, Carl L Bose, Richard J Derman, Robert L Goldenberg, Vanessa R Thorsten, Amaanti Sridhar, Dhuly Chowdhury, Abhik Das
Journal of Pediatrics 2020 September 18

OBJECTIVE: To evaluate whether the fetal linear growth effects of maternal nutrition supplementation would be maintained through 6 months postnatal age.

STUDY DESIGN: The Women First trial (WF) was a multi-country individually randomized clinical trial that compared the impact of maternal nutrition supplementation initiated preconception (Arm 1) vs at ∼11 weeks gestation (Arm 2), vs. no supplement (Arm 3); the intervention was discontinued at delivery. Trial sites were Democratic Republic of Congo, Guatemala, India, and Pakistan. Analysis includes 2421 infants born to 2408 randomized women. Primary outcome was the trajectory of length-for-age Z-scores (LAZ) by arm, based on assessments at birth and 1, 3, and 6 months. We fitted longitudinal models on growth from birth to 6 months using generalized estimating equations; maternal intervention effects were evaluated, adjusting for site and baseline maternal covariates.

RESULTS: Linear growth for Arms 1 and 2 was statistically greater than for Arm 3 in 3 of the 4 countries, with average pairwise mean differences in LAZ of 0.25 (95% CI, 0.15,0.35; P < .001) and 0.19 (95% CI, 0.09,0.28; P<0.001), respectively. Compared to Arm 3, average overall adjusted relative risks (95% CI) for stunting (LAZ <-2) were lower for Arms 1 and 2: 0.76 (0.66,0.87, P<0.001) and 0.77 (0.67,0.88; P<0.001), respectively.

CONCLUSIONS: Improved linear growth in early infancy observed for the 2 intervention arms supports the critical importance of maternal nutrition prior to conception and in the early phase of gestation.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"