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ABSTRACT: Background
Childhood stunting usually begins in utero and continues after birth; therefore, its reduction must involve actions across different stages of early life.Objective
We evaluated the efficacy of small-quantity, lipid-based nutrient supplements (SQ-LNSs) provided during pregnancy, lactation, and infancy on attained size by 18 mo of age.Design
In this partially double-blind, individually randomized trial, 1320 women at ≤20 wk of gestation received standard iron and folic acid (IFA group), multiple micronutrients (MMN group), or SQ-LNS (LNS group) daily until delivery, and then placebo, MMNs, or SQ-LNS, respectively, for 6 mo postpartum; infants in the LNS group received SQ-LNS formulated for infants from 6 to 18 mo of age (endline). The primary outcome was child length by 18 mo of age.Results
At endline, data were available for 85% of 1228 infants enrolled; overall mean length and length-for-age z score (LAZ) were 79.3 cm and -0.83, respectively, and 12% of the children were stunted (LAZ <-2). In analysis based on the intended treatment, mean ± SD length and LAZ for the LNS group (79.7 ± 2.9 cm and -0.69 ± 1.01, respectively) were significantly greater than for the IFA (79.1 ± 2.9 cm and -0.87 ± 0.99) and MMN (79.1 ± 2.9 cm and -0.91 ± 1.01) groups (P = 0.006 and P = 0.009, respectively). Differences were also significant for weight and weight-for-age z score but not head or midupper arm circumference, and the prevalence of stunting in the LNS group was 8.9%, compared with 13.7% in the IFA group and 12.9% in the MMN group (P = 0.12). In analysis based on actual supplement provided at enrollment, stunting prevalences were 8.9% compared with 15.1% and 11.5%, respectively (P = 0.045).Conclusion
Provision of SQ-LNSs to women from pregnancy to 6 mo postpartum and to their infants from 6 to 18 mo of age may increase the child's attained length by age 18 mo in similar settings. This trial was registered at clinicaltrials.gov as NCT00970866.
SUBMITTER: Adu-Afarwuah S
PROVIDER: S-EPMC4997301 | biostudies-literature | 2016 Sep
REPOSITORIES: biostudies-literature
Adu-Afarwuah Seth S Lartey Anna A Okronipa Harriet H Ashorn Per P Peerson Janet M JM Arimond Mary M Ashorn Ulla U Zeilani Mamane M Vosti Stephen S Dewey Kathryn G KG
The American journal of clinical nutrition 20160817 3
<h4>Background</h4>Childhood stunting usually begins in utero and continues after birth; therefore, its reduction must involve actions across different stages of early life.<h4>Objective</h4>We evaluated the efficacy of small-quantity, lipid-based nutrient supplements (SQ-LNSs) provided during pregnancy, lactation, and infancy on attained size by 18 mo of age.<h4>Design</h4>In this partially double-blind, individually randomized trial, 1320 women at ≤20 wk of gestation received standard iron and ...[more]