The effects of prenatal multiple micronutrient supplementation and small-quantity lipid-based nutrient supplementation on small vulnerable newborn types in low-income and middle-income countries: A meta-analysis of individual participant data

Simple item page
cg.authorship.typesCGIAR and advanced research instituteen_US
cg.authorship.typesNot CGIAR developing country instituteen_US
cg.contributor.affiliationGeorge Mason Universityen_US
cg.contributor.affiliationBoston Children's Hospitalen_US
cg.contributor.affiliationUniversity of South Carolinaen_US
cg.contributor.affiliationHarvard Universityen_US
cg.contributor.affiliationInternational Food Policy Research Instituteen_US
cg.contributor.donorBill & Melinda Gates Foundationen_US
cg.contributor.initiativeSustainable Healthy Dietsen_US
cg.creator.identifierLieven Huybregts: 0000-0002-3068-2853en_US
cg.howPublishedFormally Publisheden_US
cg.identifier.doihttps://doi.org/10.1016/s2214-109x(24)00449-2en_US
cg.identifier.projectIFPRI - Nutrition, Diets, and Health Uniten_US
cg.identifier.publicationRankA Plusen_US
cg.isijournalISI Journalen_US
cg.issn2214-109Xen_US
cg.issue2en_US
cg.journalLancet Global Healthen_US
cg.reviewStatusPeer Reviewen_US
cg.subject.impactAreaNutrition, health and food securityen_US
cg.volume13en_US
dc.contributor.authorWang, Dongqingen_US
dc.contributor.authorLiu, Enjuen_US
dc.contributor.authorPerumal, Nanditaen_US
dc.contributor.authorPartap, Uttaraen_US
dc.contributor.authorCliffer, Ilana R.en_US
dc.contributor.authorCosta, Janaína Caluen_US
dc.contributor.authorWang, Molinen_US
dc.contributor.authorFawzi, Wafaie W.en_US
dc.contributor.authorAdu-Afarwuah, Sethen_US
dc.contributor.authorAshorn, Peren_US
dc.contributor.authorAshorn, Ullaen_US
dc.contributor.authorMridha, Malay Kantien_US
dc.contributor.authorArifeen, Shamsen_US
dc.contributor.authorBhutta, Zulfiqar A.en_US
dc.contributor.authorCheng, Yueen_US
dc.contributor.authorChristian, Parulen_US
dc.contributor.authorCostello, Anthony M.en_US
dc.contributor.authorDewey, Kathryn G.en_US
dc.contributor.authorFriis, Henriken_US
dc.contributor.authorGomo, Exneviaen_US
dc.contributor.authorGrais, Rebeccaen_US
dc.contributor.authorGuindo, Ousmaneen_US
dc.contributor.authorKrebs, Nancy F.en_US
dc.contributor.authorHuybregts, Lievenen_US
dc.contributor.authorIsanaka, Sheilaen_US
dc.contributor.authorLachat, Carlen_US
dc.contributor.authorLartey, Annaen_US
dc.contributor.authorLeClerq, Steven C.en_US
dc.contributor.authorMaleta, Kennethen_US
dc.contributor.authorManandhar, Dharma S.en_US
dc.contributor.authorMartorell, Reynaldoen_US
dc.contributor.authorMatias, Susana L.en_US
dc.contributor.authorMcClure, Elizabeth M.en_US
dc.contributor.authorMoore, Sophie E.en_US
dc.contributor.authorOsrin, Daviden_US
dc.contributor.authorUrassa, Willyen_US
dc.contributor.authorPembe, Andrea B.en_US
dc.contributor.authorPrentice, Andrew M.en_US
dc.contributor.authorRamakrishnan, Ushaen_US
dc.contributor.authorRivera, Juanen_US
dc.contributor.authorRizvi, Arjumanden_US
dc.contributor.authorRoberfroid, Dominiqueen_US
dc.contributor.authorShamim, Abu Ahmeden_US
dc.contributor.authorSoofi, Sajiden_US
dc.contributor.authorSchulze, Kerryen_US
dc.contributor.authorWest Jr., Keith P.en_US
dc.contributor.authorWu, Leeen_US
dc.contributor.authorZeng, Lingxiaen_US
dc.contributor.authorZhu, Zhonghaien_US
dc.date.accessioned2025-02-06T13:48:34Zen_US
dc.date.available2025-02-06T13:48:34Zen_US
dc.identifier.urihttps://hdl.handle.net/10568/172863en_US
dc.titleThe effects of prenatal multiple micronutrient supplementation and small-quantity lipid-based nutrient supplementation on small vulnerable newborn types in low-income and middle-income countries: A meta-analysis of individual participant dataen_US
dcterms.abstractBackground Small vulnerable newborn types, defined by combinations of being born too soon or too small, have distinct determinants and health consequences. We aimed to assess the effects of prenatal multiple micronutrient supplementation (MMS) and small-quantity lipid-based nutrient supplementation (SQ-LNS) on small vulnerable newborn types, which are currently unknown. Methods In this meta-analysis, individual participant data from randomised controlled trials of MMS and randomised controlled trials of SQ-LNS in low-income and middle-income countries were used. We systematically searched the literature using PubMed, Embase, and Web of Science to identify randomised controlled trials of prenatal nutritional supplementation using MMS or SQ-LNS among pregnant people published between Jan 1, 2000, and Dec 31, 2021. Studies were excluded if they were conducted exclusively among participants selected by pre-existing health conditions, such as anaemia status, HIV infection, or diabetes. We contacted the corresponding authors of all identified studies to seek data contribution. As individual participant data became available, we mapped relevant variables and harmonised the data across studies. Iron and folic acid supplementation was the control group in most studies. Newborns were classified into ten groups through the combinations of preterm or term birth, small, appropriate, and large for gestational age, and low birthweight (LBW) or non-LBW. Newborns were also analysed using a four-group categorisation of preterm or term and LBW or non-LBW. Log-binomial models were used to estimate study-specific risk ratios (RRs), which were pooled using meta-analyses. Findings 14 randomised controlled trials of MMS (n=42 618; the mean maternal age at study enrolment was 24·3 years [SD 5.6]; 22 086 [51·8%] male neonates and 20 532 [48·2%] female neonates) and four randomised controlled trials of SQ-LNS (n=6246; the mean maternal age at study enrolment was 23·3 years [SD 5·3]; 3137 [50·2%] male neonates and 3109 [49·8%] female neonates) were used. In the ten-group categorisation of small vulnerable newborns, prenatal MMS reduced the risk of preterm–small for gestational age (SGA)–LBW (RR 0·73, 95% CI 0·64–0·84; p=0·0003); preterm–appropriate for gestational age (AGA)–LBW (0·82, 0·74–0·91; p=0·0010); preterm–AGA–non-LBW (0·89, 0·80–0·98; p=0·019); term–SGA–LBW (0·91, 0·85–0·96; p=0·0046); and term–SGA–non-LBW (0·95, 0·90–1·00; p=0·050). In the four-group categorisation, prenatal MMS reduced the risk of preterm–SGA (0·71, 0·62–0·82; p=0·0002) and term–SGA (0·93, 0·89–0·98; p=0·0066). Prenatal SQ-LNS had no significant effects on the risk of giving birth to small vulnerable newborns except for preterm–large for gestational age–non-LBW in the ten-group categorisation (0·78, 0·65–0·94; p=0·023). Interpretation Prenatal MMS and SQ-LNS reduce the risk of giving birth to small vulnerable newborns to varying extents, with the greatest magnitude of effects observed for small vulnerable newborn types that confer the greatest neonatal mortality risk. This study underscores the importance of nutritional supplements in prenatal care.en_US
dcterms.accessRightsOpen Accessen_US
dcterms.audienceAcademicsen_US
dcterms.available2025-01-29en_US
dcterms.bibliographicCitationWang, Dongqing; Liu, Enju; Perumal, Nandita; Partap, Uttara; Cliffer, Ilana R.; Costa, Janaína Calu; Wang, Molin; Fawzi, Wafaie W.; and the Gestational Weight Gain Pooling Project Consortium. 2025. The effects of prenatal multiple micronutrient supplementation and small-quantity lipid-based nutrient supplementation on small vulnerable newborn types in low-income and middle-income countries: A meta-analysis of individual participant data. Lancet Global Health 13(2): e298-e308. https://doi.org/10.1016/S2214-109X(24)00449-2en_US
dcterms.extente298-e308en_US
dcterms.issued2025-02en_US
dcterms.languageenen_US
dcterms.licenseCC-BY-4.0en_US
dcterms.publisherElsevieren_US
dcterms.subjectinfantsen_US
dcterms.subjectprematurityen_US
dcterms.subjecthealthen_US
dcterms.subjectperinatal perioden_US
dcterms.subjectmicronutrient deficienciesen_US
dcterms.subjectnutritionen_US
dcterms.typeJournal Articleen_US

Files

License bundle

Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.75 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

IFPRI Journal Articles
CGIAR Initiative on Sustainable Healthy Diets