Bibliographic Details
| Title: |
Effectiveness of nutritional supplementation during the first 1000-days of life to reduce child undernutrition: A cluster randomized controlled trial in Pakistan |
| Authors: |
Sajid Bashir Soofi, Gul Nawaz Khan, Shabina Ariff, Yasir Ihtesham, Mahamadou Tanimoune, Arjumand Rizvi, Muhammad Sajid, Cecilia Garzon, Saskia de Pee, Zulfiqar A. Bhutta |
| Source: |
The Lancet Regional Health - Southeast Asia, Vol 4, Iss , Pp 100035- (2022) |
| Publisher Information: |
Elsevier, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Public aspects of medicine |
| Subject Terms: |
Wheat soya blend plus, Lipid-based nutrient supplement, Stunting, Underweight, Wasting, Public aspects of medicine, RA1-1270 |
| More Details: |
Summary: Background: Childhood stunting can start in the womb and continue for two years. Therefore, the first 1000 days of life between a woman's pregnancy and her child's 2nd birthday offer a unique window of opportunity to build healthier and more prosperous futures. Therefore, we aimed to assess the effectiveness of nutritional supplementation during the first 1000-days to reduce the prevalence of stunting in children at 24 months of age. Methods: In this cluster randomized controlled trial, we enrolled women during their pregnancy from two rural districts of Sindh, Pakistan. A cluster was one union council with a population of ∼25000 residents. Out of 29 clusters, we randomly allocated 6 clusters to the intervention and control groups each. Pregnant women received a monthly supply of 5 kg (i.e., 165 grams/day) of wheat soya blend plus (WSB+) during pregnancy and the first six months of their lactation period. In addition, their children received lipid-based nutrient supplement - medium-quantity (LNS-MQ) between 6-23 months of age. The primary outcome was a reduction in the prevalence of stunting in children at 24 months of age. Analysis was an intention to treat. The trial is registered on ClinicalTrial.gov, number NCT02422953. Findings: Two thousand thirty pregnant women (1017 in the intervention group and 1013 in the control group) were enrolled between August 30, 2014, and May 25, 2016. Monthly follow-ups were conducted between October 1, 2014, and October 25, 2018. At 24 months of age, we captured data from 699 (78%) of 892 live births in the intervention group and 653 (76%) of 853 live births in the control group. There was a significant difference in mean length (49.4 cm vs 48.9 cm, p =0.027), weight (3.1 kg vs 3.0 kg, p =0.013), length for age z-scores (-1.2 vs -1.5, p =0.004) and weight for age z-scores (-1.2 vs -1.5, p =0.015) among infants in the intervention compared to control group. At 24 months of age, a significant difference in the prevalence of stunting (absolute difference, 10.2%, 95% CI 18.2 to 2.3, p =0.017) and underweight (absolute difference, 13.7%, 95% CI 20.3 to 7.0, p =0.001) were observed in the intervention as compared to the control group. The prevalence of wasting was not significantly different between the intervention and control groups (absolute difference, 6.9%, 95% CI 14.1 to 0.3, p =0.057). Interpretation: Provision of WSB+ and LNS-MQ during the first 1000-days of life improved child linear growth and reduced stunting in children at 24 months. This study can be scaled-up in similar settings to lower the prevalence of stunting in children under two years of age. Funding: World Food Programme, Pakistan |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2772-3682 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S2772368222000452; https://doaj.org/toc/2772-3682 |
| DOI: |
10.1016/j.lansea.2022.100035 |
| Access URL: |
https://doaj.org/article/e9ca8a4e63e0454aabe2221fc3b8e44a |
| Accession Number: |
edsdoj.9ca8a4e63e0454aabe2221fc3b8e44a |
| Database: |
Directory of Open Access Journals |
