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Association between prenatal provision of lipid-based nutrient supplements and caesarean delivery: Findings from a randomised controlled trial in Malawi.
Salenius, Meeri; Pyykkö, Juha; Ashorn, Ulla; Dewey, Kathryn G; Gondwe, Austrida; Harjunmaa, Ulla; Maleta, Kenneth; Nkhoma, Minyanga; Vosti, Stephen A; Ashorn, Per; Adubra, Laura.
Afiliación
  • Salenius M; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
  • Pyykkö J; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
  • Ashorn U; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
  • Dewey KG; Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, California, USA.
  • Gondwe A; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
  • Harjunmaa U; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
  • Maleta K; School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
  • Nkhoma M; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
  • Vosti SA; Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, California, USA.
  • Ashorn P; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
  • Adubra L; Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
Matern Child Nutr ; 18(4): e13414, 2022 10.
Article en En | MEDLINE | ID: mdl-35909334
In populations with a high prevalence of childhood and adolescent undernutrition, supplementation during pregnancy aiming at improving maternal nutritional status and preventing fetal growth restriction might theoretically lead to cephalopelvic disproportion and delivery complications. We investigated whether the prenatal provision of small-quantity lipid-based nutrient supplements (SQ-LNS) was associated with an increased risk of caesarean section (CS) or other delivery complications. Pregnant Malawian women were randomised to receive daily i) iron-folic acid (IFA) capsule (control), ii) multiple micronutrient (MMN) capsule of 18 micronutrients (second control), or iii) SQ-LNS with similar micronutrients as MMN, plus four minerals and macronutrients contributing 118 kcal. We analysed the associations of SQ-LNS, CS, and other delivery complications using log-binomial regressions. Among 1391 women enrolled, 1255 had delivery information available. The incidence of CS and delivery complications was 6.3% and 8.2%, respectively. The incidence of CS was 4.0%, 6.0%, and 8.9% (p = 0.017) in the IFA, MMN, and LNS groups, respectively. Compared to the IFA group, the relative risk (95% confidence interval) of CS was 2.2 (1.3-3.8) (p = 0.006) in the LNS group and 1.5 (0.8-2.7) (p = 0.200) in the MMN group. We found no significant differences for other delivery complications. Provision of SQ-LNS to pregnant women may have increased the incidence of CS. The baseline rate was, however, lower than recommended. It is unclear if the higher CS incidence in the SQ-LNS group resulted from increased obstetric needs or more active health seeking and a better supply of services. Trial registered at clinicaltrials.gov, NCT01239693.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Micronutrientes Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Risk_factors_studies Límite: Adolescent / Female / Humans / Pregnancy País/Región como asunto: Africa Idioma: En Revista: Matern Child Nutr Asunto de la revista: CIENCIAS DA NUTRICAO / PERINATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Micronutrientes Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Risk_factors_studies Límite: Adolescent / Female / Humans / Pregnancy País/Región como asunto: Africa Idioma: En Revista: Matern Child Nutr Asunto de la revista: CIENCIAS DA NUTRICAO / PERINATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido