Effects of prenatal multiple micronutrient supplementation on fetal growth factors

A cluster-randomized, controlled trial in rural Bangladesh

Alison Diane Gernand, Kerry J. Schulze, Ashika Nanayakkara-Bind, Margia Arguello, Abu Ahmed Shamim, Hasmot Ali, Lee Wu, Keith P. West, Parul Christian

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Prenatal multiple micronutrient (MM) supplementation improves birth weight through increased fetal growth and gestational age, but whether maternal or fetal growth factors are involved is unclear. Our objective was to examine the effect of prenatal MM supplementation on intrauterine growth factors and the associations between growth factors and birth outcomes in a rural setting in Bangladesh. In a double-blind, cluster-randomized, controlled trial of MM vs. iron and folic acid (IFA) supplementation, we measured placental growth hormone (PGH) at 10 weeks and PGH and human placental lactogen (hPL) at 32 weeks gestation in maternal plasma (n = 396) and insulin, insulin-like growth factor-1 (IGF-1), and IGF binding protein-1 (IGFBP-1) in cord plasma (n = 325). Birth size and gestational age were also assessed. Early pregnancy mean (SD) BMI was 19.5 (2.4) kg/m2 and birth weight was 2.68 (0.41) kg. There was no effect of MM on concentrations of maternal hPL or PGH, or cord insulin, IGF-1, or IGFBP-1. However, among pregnancies of female offspring, hPL concentration was higher by 1.1 mg/L in the third trimester (95% CI: 0.2, 2.0 mg/L; p = 0.09 for interaction); and among women with height <145 cm, insulin was higher by 59% (95% CI: 3, 115%; p = 0.05 for interaction) in the MM vs. IFA group. Maternal hPL and cord blood insulin and IGF-1 were positively, and IGFBP-1 was negatively, associated with birth weight z score and other measures of birth size (all p<0.05). IGF-1 was inversely associated with gestational age (p<0.05), but other growth factors were not associated with gestational age or preterm birth. Prenatal MM supplementation had no overall impact on intrauterine growth factors. MM supplementation altered some growth factors differentially by maternal early pregnancy nutritional status and sex of the offspring, but this should be examined in other studies.

Original languageEnglish (US)
Article numbere0137269
JournalPloS one
Volume10
Issue number10
DOIs
StatePublished - Oct 2 2015

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Bangladesh
Micronutrients
fetal development
Fetal Development
dietary minerals
growth factors
choriomammotropin
Intercellular Signaling Peptides and Proteins
Randomized Controlled Trials
Placental Lactogen
placental hormones
gestational age
Gestational Age
Placental Hormones
somatomedins
Insulin-Like Growth Factor Binding Protein 1
Mothers
insulin-like growth factor binding proteins
insulin
Birth Weight

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Gernand, Alison Diane ; Schulze, Kerry J. ; Nanayakkara-Bind, Ashika ; Arguello, Margia ; Shamim, Abu Ahmed ; Ali, Hasmot ; Wu, Lee ; West, Keith P. ; Christian, Parul. / Effects of prenatal multiple micronutrient supplementation on fetal growth factors : A cluster-randomized, controlled trial in rural Bangladesh. In: PloS one. 2015 ; Vol. 10, No. 10.
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abstract = "Prenatal multiple micronutrient (MM) supplementation improves birth weight through increased fetal growth and gestational age, but whether maternal or fetal growth factors are involved is unclear. Our objective was to examine the effect of prenatal MM supplementation on intrauterine growth factors and the associations between growth factors and birth outcomes in a rural setting in Bangladesh. In a double-blind, cluster-randomized, controlled trial of MM vs. iron and folic acid (IFA) supplementation, we measured placental growth hormone (PGH) at 10 weeks and PGH and human placental lactogen (hPL) at 32 weeks gestation in maternal plasma (n = 396) and insulin, insulin-like growth factor-1 (IGF-1), and IGF binding protein-1 (IGFBP-1) in cord plasma (n = 325). Birth size and gestational age were also assessed. Early pregnancy mean (SD) BMI was 19.5 (2.4) kg/m2 and birth weight was 2.68 (0.41) kg. There was no effect of MM on concentrations of maternal hPL or PGH, or cord insulin, IGF-1, or IGFBP-1. However, among pregnancies of female offspring, hPL concentration was higher by 1.1 mg/L in the third trimester (95{\%} CI: 0.2, 2.0 mg/L; p = 0.09 for interaction); and among women with height <145 cm, insulin was higher by 59{\%} (95{\%} CI: 3, 115{\%}; p = 0.05 for interaction) in the MM vs. IFA group. Maternal hPL and cord blood insulin and IGF-1 were positively, and IGFBP-1 was negatively, associated with birth weight z score and other measures of birth size (all p<0.05). IGF-1 was inversely associated with gestational age (p<0.05), but other growth factors were not associated with gestational age or preterm birth. Prenatal MM supplementation had no overall impact on intrauterine growth factors. MM supplementation altered some growth factors differentially by maternal early pregnancy nutritional status and sex of the offspring, but this should be examined in other studies.",
author = "Gernand, {Alison Diane} and Schulze, {Kerry J.} and Ashika Nanayakkara-Bind and Margia Arguello and Shamim, {Abu Ahmed} and Hasmot Ali and Lee Wu and West, {Keith P.} and Parul Christian",
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Gernand, AD, Schulze, KJ, Nanayakkara-Bind, A, Arguello, M, Shamim, AA, Ali, H, Wu, L, West, KP & Christian, P 2015, 'Effects of prenatal multiple micronutrient supplementation on fetal growth factors: A cluster-randomized, controlled trial in rural Bangladesh', PloS one, vol. 10, no. 10, e0137269. https://doi.org/10.1371/journal.pone.0137269

Effects of prenatal multiple micronutrient supplementation on fetal growth factors : A cluster-randomized, controlled trial in rural Bangladesh. / Gernand, Alison Diane; Schulze, Kerry J.; Nanayakkara-Bind, Ashika; Arguello, Margia; Shamim, Abu Ahmed; Ali, Hasmot; Wu, Lee; West, Keith P.; Christian, Parul.

In: PloS one, Vol. 10, No. 10, e0137269, 02.10.2015.

Research output: Contribution to journalArticle

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T2 - A cluster-randomized, controlled trial in rural Bangladesh

AU - Gernand, Alison Diane

AU - Schulze, Kerry J.

AU - Nanayakkara-Bind, Ashika

AU - Arguello, Margia

AU - Shamim, Abu Ahmed

AU - Ali, Hasmot

AU - Wu, Lee

AU - West, Keith P.

AU - Christian, Parul

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