TY - JOUR
T1 - A prenatal multiple micronutrient supplement produces higher maternal vitamin B-12 concentrations and similar folate, ferritin, and zinc concentrations as the standard 60-mg iron plus 400-mg folic acid supplement in rural bangladeshi women
AU - Ziaei, Shirin
AU - Rahman, Anisur
AU - Raqib, Rubhana
AU - Lönnerdal, Bo
AU - Ekström, Eva Charlotte
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background: The effects of prenatal food and micronutrient supplementation on maternal micronutrient status are not well known. Objective: We compared the efficacy and effectiveness of 3 different micronutrient supplements on maternal micronutrient status when combined with food supplementation. Methods: In the MINIMat (Maternal and Infant Nutrition Intervention, Matlab) trial in Bangladesh, 4436 pregnant women were randomly assigned to daily intake of 3 types ofmicronutrient capsules: 30mg Fe and 400 mg folic acid (Fe30F), 60mg Fe and 400 mg folic acid (Fe60F), or multiple micronutrient supplements (MMNs) combined with early (week 9 of pregnancy) or usual (week 20 of pregnancy) food supplementation in a 2 by 3 factorial design. Plasma concentrations of vitamin B-12, folate, ferritin, and zinc were analyzed before the start of micronutrient supplementation (week 14) and at week 30 of pregnancy in 641 randomly selectedwomen. An electronic monitoring device was used to measure the number of capsules taken. The effectiveness of food and micronutrient regimens as well as efficacy per capsule in maternal micronutrient status were analyzed by ANOVA and general linear models. Results: At week 30 of pregnancy, women in the MMN group had higher geometric mean concentrations of vitamin B-12 than women in the Fe60F group (119 compared with 101 pmol/L, respectively); no other differences in effectiveness of micronutrient and food regimens were observed. A dose-response relation between the number of capsules taken and concentrations of folate and ferritin was observed for all micronutrient supplements. Fe30F had lower efficacy per capsule in increasing ferritin concentrations within the first tertile of capsule intake than did Fe60F andMMNs. Because ferritin reached a plateau for all types of micronutrient supplements, there was no difference between the regimens in their effectiveness. Conclusion: Compared with Fe60F, MMNs produced higher maternal vitamin B-12 and similar ferritin and folate concentrations in Bangladeshi women.
AB - Background: The effects of prenatal food and micronutrient supplementation on maternal micronutrient status are not well known. Objective: We compared the efficacy and effectiveness of 3 different micronutrient supplements on maternal micronutrient status when combined with food supplementation. Methods: In the MINIMat (Maternal and Infant Nutrition Intervention, Matlab) trial in Bangladesh, 4436 pregnant women were randomly assigned to daily intake of 3 types ofmicronutrient capsules: 30mg Fe and 400 mg folic acid (Fe30F), 60mg Fe and 400 mg folic acid (Fe60F), or multiple micronutrient supplements (MMNs) combined with early (week 9 of pregnancy) or usual (week 20 of pregnancy) food supplementation in a 2 by 3 factorial design. Plasma concentrations of vitamin B-12, folate, ferritin, and zinc were analyzed before the start of micronutrient supplementation (week 14) and at week 30 of pregnancy in 641 randomly selectedwomen. An electronic monitoring device was used to measure the number of capsules taken. The effectiveness of food and micronutrient regimens as well as efficacy per capsule in maternal micronutrient status were analyzed by ANOVA and general linear models. Results: At week 30 of pregnancy, women in the MMN group had higher geometric mean concentrations of vitamin B-12 than women in the Fe60F group (119 compared with 101 pmol/L, respectively); no other differences in effectiveness of micronutrient and food regimens were observed. A dose-response relation between the number of capsules taken and concentrations of folate and ferritin was observed for all micronutrient supplements. Fe30F had lower efficacy per capsule in increasing ferritin concentrations within the first tertile of capsule intake than did Fe60F andMMNs. Because ferritin reached a plateau for all types of micronutrient supplements, there was no difference between the regimens in their effectiveness. Conclusion: Compared with Fe60F, MMNs produced higher maternal vitamin B-12 and similar ferritin and folate concentrations in Bangladeshi women.
KW - Bangladesh
KW - Effectiveness
KW - Efficacy
KW - Ferritin
KW - Folate
KW - Food supplementation
KW - Maternal micronutrient status
KW - Prenatal micronutrient supplementation
KW - Vitamin B-12
KW - Zinc
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U2 - 10.3945/jn.116.235994
DO - 10.3945/jn.116.235994
M3 - Article
C2 - 27798335
AN - SCOPUS:85006998578
VL - 146
SP - 2520
EP - 2529
JO - Journal of Nutrition
JF - Journal of Nutrition
SN - 0022-3166
IS - 12
ER -