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Impact of small-quantity lipid-based nutrient supplement on hemoglobin, iron status and biomarkers of inflammation in pregnant Ghanaian women.
Matern Child Nutr. 2017 04; 13(2)MC

Abstract

We examined hemoglobin (Hb, g/L), iron status (zinc protoporphyrin, ZPP, µmol/mol heme, and transferrin receptor, TfR, mg/L) and inflammation (C-reactive protein, CRP and alpha-1 glycoprotein, AGP) in pregnant Ghanaian women who participated in a randomized controlled trial. Women (n = 1320) received either 60 mg Fe + 400-µg folic acid (IFA); 18 micronutrients including 20-mg Fe (MMN) or small-quantity lipid-based nutrient supplements (SQ-LNS, 118 kcal/d) with the same micronutrient levels as in MMN, plus four additional minerals (LNS) daily during pregnancy. Intention-to-treat analysis included 349, 354 and 354 women in the IFA, MMN and LNS groups, respectively, with overall baseline mean Hb and anemia (Hb <100) prevalence of 112 and 13.3%, respectively. At 36 gestational weeks, overall Hb was 117, and anemia prevalence was 5.3%. Compared with the IFA group, the LNS and MMN groups had lower mean Hb (120 ± 11 vs. 115 ± 12 and 117 ± 12, respectively; P < 0.001), higher mean ZPP (42 ± 30 vs. 50 ± 29 and 49 ± 30; P = 0.010) and TfR (4.0 ± 1.3 vs. 4.9 ± 1.8 and 4.6 ± 1.7; P < 0.001), and greater prevalence of anemia (2.2% vs. 7.9% and 5.8%; P = 0.019), elevated ZPP (>60) [9.4% vs. 18.6% and 19.2%; P = 0.003] and elevated TfR (>6.0) [9.0% vs. 19.2% and 15.1%; P = 0.004]. CRP and AGP concentrations did not differ among groups. We conclude that among pregnant women in a semi-urban setting in Ghana, supplementation with SQ-LNS or MMN containing 20 mg iron resulted in lower Hb and iron status but had no impact on inflammation, when compared with iron (60 mg) plus folic acid (400 µg). The amount of iron in such supplements that is most effective for improving both maternal Hb/iron status and birth outcomes requires further evaluation. This trial was registered at ClinicalTrials.gov as: NCT00970866.

Authors+Show Affiliations

Department of Nutrition and Food Science, University of Ghana, Accra, Ghana.Department of Nutrition and Food Science, University of Ghana, Accra, Ghana.Department of Nutrition and Food Science, University of Ghana, Accra, Ghana.Center for Child Health Research and Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Finland.Nutriset S.A.S., Malaunay, France.Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26924599

Citation

Adu-Afarwuah, Seth, et al. "Impact of Small-quantity Lipid-based Nutrient Supplement On Hemoglobin, Iron Status and Biomarkers of Inflammation in Pregnant Ghanaian Women." Maternal & Child Nutrition, vol. 13, no. 2, 2017.
Adu-Afarwuah S, Lartey A, Okronipa H, et al. Impact of small-quantity lipid-based nutrient supplement on hemoglobin, iron status and biomarkers of inflammation in pregnant Ghanaian women. Matern Child Nutr. 2017;13(2).
Adu-Afarwuah, S., Lartey, A., Okronipa, H., Ashorn, P., Zeilani, M., Baldiviez, L. M., Oaks, B. M., Vosti, S., & Dewey, K. G. (2017). Impact of small-quantity lipid-based nutrient supplement on hemoglobin, iron status and biomarkers of inflammation in pregnant Ghanaian women. Maternal & Child Nutrition, 13(2). https://doi.org/10.1111/mcn.12262
Adu-Afarwuah S, et al. Impact of Small-quantity Lipid-based Nutrient Supplement On Hemoglobin, Iron Status and Biomarkers of Inflammation in Pregnant Ghanaian Women. Matern Child Nutr. 2017;13(2) PubMed PMID: 26924599.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of small-quantity lipid-based nutrient supplement on hemoglobin, iron status and biomarkers of inflammation in pregnant Ghanaian women. AU - Adu-Afarwuah,Seth, AU - Lartey,Anna, AU - Okronipa,Harriet, AU - Ashorn,Per, AU - Zeilani,Mamane, AU - Baldiviez,Lacey M, AU - Oaks,Brietta M, AU - Vosti,Stephen, AU - Dewey,Kathryn G, Y1 - 2016/02/29/ PY - 2015/08/20/received PY - 2015/11/11/revised PY - 2015/11/17/accepted PY - 2016/3/1/pubmed PY - 2017/10/28/medline PY - 2016/3/1/entrez KW - LNS KW - hemoglobin KW - inflammation KW - iron status KW - lipid-based nutrient supplements KW - multiple micronutrients KW - prenatal supplementation JF - Maternal & child nutrition JO - Matern Child Nutr VL - 13 IS - 2 N2 - We examined hemoglobin (Hb, g/L), iron status (zinc protoporphyrin, ZPP, µmol/mol heme, and transferrin receptor, TfR, mg/L) and inflammation (C-reactive protein, CRP and alpha-1 glycoprotein, AGP) in pregnant Ghanaian women who participated in a randomized controlled trial. Women (n = 1320) received either 60 mg Fe + 400-µg folic acid (IFA); 18 micronutrients including 20-mg Fe (MMN) or small-quantity lipid-based nutrient supplements (SQ-LNS, 118 kcal/d) with the same micronutrient levels as in MMN, plus four additional minerals (LNS) daily during pregnancy. Intention-to-treat analysis included 349, 354 and 354 women in the IFA, MMN and LNS groups, respectively, with overall baseline mean Hb and anemia (Hb <100) prevalence of 112 and 13.3%, respectively. At 36 gestational weeks, overall Hb was 117, and anemia prevalence was 5.3%. Compared with the IFA group, the LNS and MMN groups had lower mean Hb (120 ± 11 vs. 115 ± 12 and 117 ± 12, respectively; P < 0.001), higher mean ZPP (42 ± 30 vs. 50 ± 29 and 49 ± 30; P = 0.010) and TfR (4.0 ± 1.3 vs. 4.9 ± 1.8 and 4.6 ± 1.7; P < 0.001), and greater prevalence of anemia (2.2% vs. 7.9% and 5.8%; P = 0.019), elevated ZPP (>60) [9.4% vs. 18.6% and 19.2%; P = 0.003] and elevated TfR (>6.0) [9.0% vs. 19.2% and 15.1%; P = 0.004]. CRP and AGP concentrations did not differ among groups. We conclude that among pregnant women in a semi-urban setting in Ghana, supplementation with SQ-LNS or MMN containing 20 mg iron resulted in lower Hb and iron status but had no impact on inflammation, when compared with iron (60 mg) plus folic acid (400 µg). The amount of iron in such supplements that is most effective for improving both maternal Hb/iron status and birth outcomes requires further evaluation. This trial was registered at ClinicalTrials.gov as: NCT00970866. SN - 1740-8709 UR - https://www.unboundmedicine.com/medline/citation/26924599/Impact_of_small_quantity_lipid_based_nutrient_supplement_on_hemoglobin_iron_status_and_biomarkers_of_inflammation_in_pregnant_Ghanaian_women_ L2 - https://doi.org/10.1111/mcn.12262 DB - PRIME DP - Unbound Medicine ER -