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Effect of a micronutrient-rich snack taken preconceptionally and throughout pregnancy on ultrasound measures of fetal growth: The Mumbai Maternal Nutrition Project (MMNP)

Effect of a micronutrient-rich snack taken preconceptionally and throughout pregnancy on ultrasound measures of fetal growth: The Mumbai Maternal Nutrition Project (MMNP)
Effect of a micronutrient-rich snack taken preconceptionally and throughout pregnancy on ultrasound measures of fetal growth: The Mumbai Maternal Nutrition Project (MMNP)

Improving micronutrient intakes of under-nourished mothers in low- and middle-income countries increases birth weight, but there is little data on the nature and timing during gestation of any effects on fetal growth. Ultrasound measures of fetal size were used to determine whether and when a food-based supplement affected fetal growth. Non-pregnant women living in Mumbai slums, India (N = 6,513), were randomly assigned to receive either a daily micronutrient-rich snack containing green leafy vegetables, fruit, and milk (treatment) or a snack made from lower-micronutrient vegetables (control) in addition to their usual diet from before pregnancy until delivery. From 2,291 pregnancies, the analysis sample comprised 1,677 fetuses (1,335 fetuses of women supplemented for ≥3 months before conception). First-trimester (median: 10 weeks, interquartile range: 9–12 weeks) fetal crown-rump length was measured. Fetal head circumference, biparietal diameter, femur length, and abdominal circumference were measured during the second (19, 19–20 weeks) and third trimesters (29, 28–30 weeks). The intervention had no effect on fetal size or growth at any stage of pregnancy. In the second trimester, there were interactions between parity and allocation group for biparietal diameter (p =.02) and femur length (p =.04) with both being smaller among fetuses of primiparous women and larger among those of multiparous women, in the treatment group compared with the controls. Overall, a micronutrient-rich supplement did not increase standard ultrasound measures of fetal size and growth at any stage of pregnancy. Additional ultrasound measures of fetal soft tissues (fat and muscle) may be informative.

fetal growth, food-based supplement, India, pregnancy, randomised controlled trial, ultrasound
1740-8695
1-12
Lawande, Ashwin
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Di Gravio, Chiara
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Potdar, Ramesh D.
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Sahariah, Sirazul A.
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Gandhi, Meera
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Chopra, Harsha
174374ab-3bc9-40bf-ab19-8e32685c0f12
Sane, Harshad
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Kehoe, Sarah H.
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Marley-Zagar, Ella
72889f31-25ea-4894-95f3-98e0e4acd522
Margetts, Barrie M.
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Jackson, Alan A.
c9a12d7c-b4d6-4c92-820e-890a688379ef
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18
Lawande, Ashwin
8987dc70-5e5c-46a9-a9da-5fe8e1c68b18
Di Gravio, Chiara
4033fc31-5d17-4329-b741-aee8ba31d971
Potdar, Ramesh D.
62aa063e-47ba-46ca-bbc6-290b6dbc4202
Sahariah, Sirazul A.
00647542-3ca0-44e4-b3bc-f0c84228f7e6
Gandhi, Meera
e93389ce-a779-4087-8150-d780a9b4206b
Chopra, Harsha
174374ab-3bc9-40bf-ab19-8e32685c0f12
Sane, Harshad
c9f9919e-503f-4066-bf3c-9893076dc9d1
Kehoe, Sarah H.
534e5729-632b-4b4f-8401-164d8c20aa26
Marley-Zagar, Ella
72889f31-25ea-4894-95f3-98e0e4acd522
Margetts, Barrie M.
d415f4a1-d572-4ebc-be25-f54886cb4788
Jackson, Alan A.
c9a12d7c-b4d6-4c92-820e-890a688379ef
Fall, Caroline H.D.
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Lawande, Ashwin, Di Gravio, Chiara, Potdar, Ramesh D., Sahariah, Sirazul A., Gandhi, Meera, Chopra, Harsha, Sane, Harshad, Kehoe, Sarah H., Marley-Zagar, Ella, Margetts, Barrie M., Jackson, Alan A. and Fall, Caroline H.D. (2018) Effect of a micronutrient-rich snack taken preconceptionally and throughout pregnancy on ultrasound measures of fetal growth: The Mumbai Maternal Nutrition Project (MMNP). Maternal & Child Nutrition, 14 (1), 1-12, [e12441]. (doi:10.1111/mcn.12441).

Record type: Article

Abstract

Improving micronutrient intakes of under-nourished mothers in low- and middle-income countries increases birth weight, but there is little data on the nature and timing during gestation of any effects on fetal growth. Ultrasound measures of fetal size were used to determine whether and when a food-based supplement affected fetal growth. Non-pregnant women living in Mumbai slums, India (N = 6,513), were randomly assigned to receive either a daily micronutrient-rich snack containing green leafy vegetables, fruit, and milk (treatment) or a snack made from lower-micronutrient vegetables (control) in addition to their usual diet from before pregnancy until delivery. From 2,291 pregnancies, the analysis sample comprised 1,677 fetuses (1,335 fetuses of women supplemented for ≥3 months before conception). First-trimester (median: 10 weeks, interquartile range: 9–12 weeks) fetal crown-rump length was measured. Fetal head circumference, biparietal diameter, femur length, and abdominal circumference were measured during the second (19, 19–20 weeks) and third trimesters (29, 28–30 weeks). The intervention had no effect on fetal size or growth at any stage of pregnancy. In the second trimester, there were interactions between parity and allocation group for biparietal diameter (p =.02) and femur length (p =.04) with both being smaller among fetuses of primiparous women and larger among those of multiparous women, in the treatment group compared with the controls. Overall, a micronutrient-rich supplement did not increase standard ultrasound measures of fetal size and growth at any stage of pregnancy. Additional ultrasound measures of fetal soft tissues (fat and muscle) may be informative.

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Accepted/In Press date: 27 January 2017
e-pub ahead of print date: 2 March 2017
Published date: 1 January 2018
Keywords: fetal growth, food-based supplement, India, pregnancy, randomised controlled trial, ultrasound
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 405637
URI: http://eprints.soton.ac.uk/id/eprint/405637
ISSN: 1740-8695
PURE UUID: a3e2ce0b-1fce-4037-9527-7f81733b7ca5

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Date deposited: 10 Feb 2017 09:48
Last modified: 16 Dec 2019 19:27

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Contributors

Author: Ashwin Lawande
Author: Chiara Di Gravio
Author: Ramesh D. Potdar
Author: Sirazul A. Sahariah
Author: Meera Gandhi
Author: Harsha Chopra
Author: Harshad Sane
Author: Sarah H. Kehoe
Author: Ella Marley-Zagar
Author: Alan A. Jackson

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