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Effects of Food Supplementation During Pregnancy on Maternal Weight Gain, Hemoglobin Levels and Pregnancy Outcomes in Iran

  • Jafar Sadegh Tabrizi
  • Arezoo Asghari
  • Fatollah Pourali
  • Hamideh Kousha
  • Leila NikniazEmail author
Article
  • 14 Downloads

Abstract

Objectives In this study, the effects of food supplementation during pregnancy on maternal weight gain, hemoglobin (Hb) levels, and pregnancy outcomes were evaluated. Methods In this randomized controlled trial, we recruited 1360 pregnant women with a gestational age of 10 weeks who had BMI < 18.5 and hemoglobin < 10.5/dL from rural areas of the east Azerbaijan province in Iran. Rural areas were randomly assigned into two groups: food-supplemented and control areas. In food-supplemented areas the food supplement was provided (1500 kcal/d) from 10 weeks of pregnancy through to the end. Information on demographic data were collected and anthropometric and Hb measurements were taken using standard instruments. Results The average weight gain was 9.1 ± 1.8 kg and 7.9 ± 1.6 kg in supplemented and control groups respectively, which was significantly different (p = 0.001). Also, a significant time × treatment interaction in maternal average weight gain (p = 0.001) was observed. The mean Hb decreased from 12 mg/dl and 12.1 mg/dl in week 10 to 11.9 mg/dl and 11.7 mg/dl in week 20 in the supplemented and control groups respectively, which was significant only for the control group. Between-group comparisons revealed significant differences in the rates of low birth weight (LBW) infants (p = 0.001) and preterm births (p = 0.013). Conclusion for practice Food supplementation significantly reduced the prevalence of poor maternal weight gain, infants with low birth weight, and preterm births compared to no intervention.

Keywords

Food supplementation Pregnancy Maternal weight gain Hemoglobin Low birth weight 

Notes

Acknowledgements

The authors wish to thank the Tabriz Health services management research center and the East Azarbaijan health province at Tabriz University of Medical Sciences for their financial support. This study would not have been possible without the help and participation of the health centers.

References

  1. Antonio, M. Â. R. D. G., Zanolli, M. D. L., Carniel, E. D. F., & Morcillo, A. M. (2009). Factors associated with insufficient birth weight. Revista da Associação Médica Brasileira, 55(2), 153–157.CrossRefGoogle Scholar
  2. Carmichael, S. L., & Abrams, B. (1997). A critical review of the relationship between gestational weight gain and preterm delivery. Obstetrics & Gynecology, 89(5, Part 2), 865–873.CrossRefGoogle Scholar
  3. Ceesay, S. M., Prentice, A. M., Cole, T. J., Foord, F., Poskitt, E. M., Weaver, L. T., & Whitehead, R. G. (1997). Effects on birth weight and perinatal mortality of maternal dietary supplements in rural Gambia: 5 year randomised controlled trial. BMJ, 315(7111), 786–790.CrossRefGoogle Scholar
  4. Gaemmaghami, S. J., Nikniaz, L., Mahdavi, R., Nikniaz, Z., Razmifard, F., & Afsharnia, F. (2013). Effects of infants’ birth order, maternal age, and socioeconomic status on birth weight. Saudi Medical Journal, 34(9), 949–953.Google Scholar
  5. Gebremariam, A. (2005). Factors predisposing to low birth weight in Jimma Hospital south western Ethiopia. East African Medical Journal, 82(11), 554.PubMedGoogle Scholar
  6. Huybregts, L., Roberfroid, D., Lanou, H., Menten, J., Meda, N., Van Camp, J., & Kolsteren, P. (2009). Prenatal food supplementation fortified with multiple micronutrients increases birth length: A randomized controlled trial in rural Burkina Faso. The American Journal of Clinical Nutrition, 90(6), 1593–1600.CrossRefGoogle Scholar
  7. Imdad, A., & Bhutta, Z. A. (2011). Effect of balanced protein energy supplementation during pregnancy on birth outcomes. BMC Public Health, 11(3), 1.CrossRefGoogle Scholar
  8. Institute of Medicine (Subcommittees on Nutritional Status and Weight Gain During Pregnancy and Dietary Intake and Nutrient Supplements During Pregnancy, Committee on Nutritional Status During Pregnancy and Lactation). (1990). Food and nutrition board nutrition during pregnancy: Part I, weight gain; part II, nutrient supplements. Washington, DC: National Academy Press.Google Scholar
  9. Karim, M., Flora, M., & Akhter, S. (2011). Birthweight of the babies delivered by chronic energy deficient mothers in National Nutrition Program (NNP) intervention area. Bangladesh Medical Research Council Bulletin, 37(1), 17–23.CrossRefGoogle Scholar
  10. Kramer, M. S. (1987). Determinants of low birth weight: Methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65(5), 663.PubMedPubMedCentralGoogle Scholar
  11. Kramer, M. S. (1990). Birthweight and infant mortality: Perceptions and pitfalls. Paediatric and Perinatal Epidemiology, 4(4), 381–390.CrossRefGoogle Scholar
  12. Kramer, M. S. (1993). Effects of energy and protein intakes on pregnancy outcome: An overview of the research evidence from controlled clinical trials. The American Journal of Clinical Nutrition, 58(5), 627–635.CrossRefGoogle Scholar
  13. Liberato, S. C., Singh, G., & Mulholland, K. (2013). Effects of protein energy supplementation during pregnancy on fetal growth: A review of the literature focusing on contextual factors. Food & Nutrition Research. 57, 20499.CrossRefGoogle Scholar
  14. Mahajan, S. D., Singh, S., Shah, P., Gupta, N., & Kochupillai, N. (2004). Effect of maternal malnutrition and anemia on the endocrine regulation of fetal growth. Endocrine Research, 30(2), 189–203.CrossRefGoogle Scholar
  15. Makola, D., Ash, D. M., Tatala, S. R., Latham, M. C., Ndossi, G., & Mehansho, H. (2003). A micronutrient-fortified beverage prevents iron deficiency, reduces anemia and improves the hemoglobin concentration of pregnant Tanzanian women. The Journal of Nutrition, 133(5), 1339–1346.CrossRefGoogle Scholar
  16. Mardones, F., Urrutia, M.-T., Villarroel, L., Rioseco, A., Castillo, O., Rozowski, J., … Rojas, I. (2008). Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women. Public Health Nutrition, 11(01), 30–40.CrossRefGoogle Scholar
  17. Nahar, S., Mascie-Taylor, C. N., & Begum, H. A. (2009). Impact of targeted food supplementation on pregnancy weight gain and birth weight in rural Bangladesh: An assessment of the Bangladesh Integrated Nutrition Program (BINP). Public Health Nutrition, 12(08), 1205–1212.CrossRefGoogle Scholar
  18. Ortolano, S. E., Mahmud, Z., Kabir, A. I., & Levinson, F. J. (2003). Effect of targeted food supplementation and services in the Bangladesh Integrated Nutrition Project on women and their pregnancy outcomes. Journal of Health, Population and Nutrition, 2003, 83–89.Google Scholar
  19. Osrin, D., & Anthony, M. D. L. (2000). Maternal nutrition and fetal growth: Practical issues in international health. Paper presented at the Seminars in Neonatology.Google Scholar
  20. Rasmussen, K. M., & Yaktine, A. L. (2009). Determinants of gestational weight gain. Bethesda: National Center for Biotechnology Information, U.S. National Library of Medicine.Google Scholar
  21. Stoltzfus, R. J. (2001). Defining iron-deficiency anemia in public health terms: A time for reflection. The Journal of Nutrition, 131(2), 565S–567S.CrossRefGoogle Scholar
  22. Yang, Z., & Huffman, S. L. (2011). Review of fortified food and beverage products for pregnant and lactating women and their impact on nutritional status. Maternal & Child Nutrition, 7(s3), 19–43.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jafar Sadegh Tabrizi
    • 1
  • Arezoo Asghari
    • 2
  • Fatollah Pourali
    • 2
  • Hamideh Kousha
    • 2
  • Leila Nikniaz
    • 3
    Email author
  1. 1.Tabriz Health Services Management Research Center, Faculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
  2. 2.Nutrition Improvement GroupTabriz University of Medical SciencesTabrizIran
  3. 3.Tabriz Health Services Management Research CenterTabriz University of Medical SciencesTabrizIran

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