RESUMO
BACKGROUND: Maternal nutritional status is an important predictor of infant birthweight. Most previous attempts to improve birthweight through multiple micronutrient supplementation have been initiated after women are pregnant. Interventions to improve maternal nutritional status prior to conception may be more effective in preventing low birthweight and improving other infant health outcomes. OBJECTIVE: To compare the effects of maternal supplementation with animal-source food from preconception to term or from mid-gestation to term with routine prenatal care on birthweight, the prevalence of preterm births, intrauterine growth restriction, and infant growth during the first 12 months of life and on maternal nutrient status and the incidence of maternal and infant infections. METHODS: Young women from 29 rural communes in northwestern Vietnam were recruited when they registered to marry and were randomized to one of three interventions: animal-source food supplement 5 days per week from marriage to term (approximately 13 months), animal-source food supplement 5 days per week from 16 weeks of gestation to term (approximately 5 months), or routine prenatal care without supplementalfeeding. Data on infant birthweight and gestational age, maternal and infant anthropometry, micronutrient status, and infections in the infant and mother were collected at various time points. RESULTS: In a preliminary study of women of reproductive age in this area of Vietnam, 40% of the women were underweight (body mass index < 18.5) and anemic. About 50% had infections. Rice was the dietary staple, and nutrient-rich, animal-source foods were rarely consumed by women. Iron, zinc, vitamin A, folate, and vitamin B12 intakes were inadequate in about 40% of the women. The study is still ongoing, and further data are not yet available. CONCLUSIONS: The results of this study will provide important data regarding whether improved intake of micronutrient-rich animal-source foods that are locally available and affordable before and during pregnancy improves maternal and infant health and development. This food-based approach may have global implications regarding how and when to initiate sustainable nutritional interventions to improve maternal and infant health.
