TABLE 3.
Unadjusted binary anthropometric outcomes of women who participated in a randomized trial of IFA (pregnancy only), MMN (pregnancy and lactation), and LNS (pregnancy and lactation) supplementation in a semi-urban setting in Ghana, by intervention group based on intended supplement at enrollment1
| Comparison of4 |
||||||||||
| Group2 |
MMNs and IFA |
LNSs and IFA |
LNSs and MMNs |
|||||||
| IFA (n = 441) | MMN (n = 439) | LNS (n = 440) | P3 | RR (95% CI) | P | RR (95% CI) | P | RR (95% CI) | P | |
| GWG, % | ||||||||||
| Inadequate5 | 63.1 (57.8, 68.2) [331] | 67.2 (62.1, 72.0) [351] | 57.4 (52.0, 62.6) [331] | 0.030 | 1.1 (0.9, 1.2) | 0.50 | 0.9 (0.8, 1.1) | 0.29 | 0.9 (0.7, 1.0) | 0.023 |
| Adequate6 | 25.7 (21.3, 30.7) [331] | 24.2 (20.0, 29.0) [351] | 31.1 (26.4, 36.3) [331] | 0.11 | 0.9 (0.7, 1.3) | 0.90 | 1.2 (0.9, 1.6) | 0.27 | 1.3 (1.0, 1.7) | 0.11 |
| Excessive7 | 11.2 (8.2, 15.1) [331] | 8.5 (6.0, 12.0) [351] | 11.5 (8.5, 15.4) [331] | 0.38 | 0.8 (0.4, 1.3) | 0.48 | 1.0 (0.6, 1.7) | 0.99 | 1.3 (0.8, 2.3) | 0.41 |
| <10th centile of expected GWG8 | 28.5 (22.5, 35.4) [186] | 28.7 (23.0, 35.2) [209] | 23.0 (17.5, 29.6) [187] | 0.36 | 1.0 (0.7, 1.5) | 1.00 | 0.8 (0.5, 1.2) | 0.45 | 0.8 (0.5, 1.2) | 0.40 |
| >97th centile of expected GWG8 | 0 | 0 | 0 | — | — | — | — | — | — | — |
| Developed overweight or obesity by 6 mo postpartum9 | 20.9 (15.8, 27.2) [196] | 15.7 (11.5, 21.2) [216] | 17.2 (12.6, 23.0) [204] | 0.37 | 0.8 (0.5, 1.2) | 0.36 | 0.8 (0.5, 1.3) | 0.60 | 1.1 (0.6, 1.8) | 0.92 |
| Developed obesity by 6 mo postpartum10 | 0.5 (0.1, 3.5) [196] | 0.0 (0.0, 100) [216] | 0.0 (0.0, 100) [204] | 1.00 | 0.0 (0.0, 0.0) | 1.00 | 0.0 (0.0, 0.0) | 1.00 | 1.0 (0.8, 1.3) | 1.00 |
n = 1320. IFA group: women were assigned to receive 60 mg Fe + 400 mg folic acid/d during pregnancy and placebo (200 mg Ca/d) during the first 6 mo postpartum; MMN group: women were assigned to receive 18 vitamins and minerals (including 20 mg Fe)/d during pregnancy and the first 6 mo postpartum; LNS group: women were assigned to receive 20 g SQ-LNS/d with the same micronutrients as the MMN group + calcium, phosphorus, potassium, and magnesium as well as macronutrients during pregnancy and the first 6 mo postpartum. Results are based on logistic regression (SAS PROC GLIMMIX). GA, gestational age; GWG, gestational weight gain; IFA, iron and folic acid; IOM, Institute of Medicine; LNS, lipid-based nutrient supplement; MMN, multiple micronutrient; SQ-LNS, small-quantity lipid-based nutrient supplement.
Values are percentages (95% CIs) [n]. Percentages (95% CIs) are based on prepregnancy values estimated from those measured at enrollment by using third-order polynomial regression with GA at enrollment as the predictor variable.
P values for comparisons between all 3 groups, with Tukey-Kramer adjustment for pairwise comparisons.
RRs (95% CIs) and their P values are based on Poisson regression (27).
Below the lower cutoff of the IOM’s recommended range (13).
Within the IOM’s recommended range (13).
Above the upper cutoff of the IOM’s recommended range (13).
Based on INTERGROWTH-21st standards for women whose estimated prepregnancy weight was normal (BMI: 18.50–24.99). The third centile of expected GWG was calculated as follows: exp((1.382972 − 56.14743 × GA−2 + 0.2787683 × GA0.5) + {−1.88 × [0.2501993731 + 142.4297879 × GA−2 − 61.45345 × GA−2 × log(GA)]}) − 8.75, where GA = weeks of gestation at the last antenatal measurement (14). The 97th centile of expected GWG was calculated by replacing the −1.88 in the formula for the third centile of expected GWG by 1.88 (14). No woman in the entire sample had total GWG above the 97th centile of the expected GWG based on the INTERGROWTH-21st standards.
Proportion of women with normal prepregnancy BMI who became overweight or obese by 6 mo postpartum.
Proportion of women with normal prepregnancy BMI prepregnancy who became obese by 6 mo postpartum.