Food supplementation in early pregnancy reduces infant mortality

The devastating role of maternal and child malnutrition is especially prominent in South Asia. In this week’s issue of JAMA researchers from Uppsala University in collaboration with colleagues from Bangladesh and United States report significant progress in reducing the consequences of malnutrition in pregnant women.

Maternal and child malnutrition is estimated to be the underlying cause of 3.5 million annual deaths and 35 percent of the total disease burden in children younger than 5 years. Malnourished pregnant women give birth to low birth-weight babies, who have an increased risk of infant death.

In the MINIMat trial in rural Bangladesh pregnant women were randomly selected to an early start of food supplementation combined with multiple micronutrients. Their infants had 62 percent reduction in infant mortality in comparison with infants of mothers who were randomised to the standard treatment, i.e. a later start of food supplementation and iron-folate.

-    This is the first time the effect of timing of food supplementation is evaluated, combined with selected vitamins and minerals, and the size of the effect on infant survival was considerable, says professor Lars Åke Persson, who has been responsible for the study.

The positive effect on survival was not mediated by changes in the fetal growth trajectory and size at birth. However, the combination of a balanced protein-energy supplement from around week 9 with multiple micronutrients from week 14 implied a maternoplacental nutrient supply that favored healthy fetal development and infant survival with the lowest incidence of asphyxia deaths and infectious disease mortality.

Link to journal website: http://jama.ama-assn.org/

For more information, please contact Lars-Åke Persson, mobile: 070-425 09 31, e-mail: lars-ake.persson@kbh.uu.se