Small-quantity, lipid-based nutrient supplements provided to women during pregnancy and 6 mo postpartum and to their infants from 6 mo of age increase the mean attained length of 18-mo-old children in semi-urban Ghana: a randomized controlled trial
What this study found
SQ-LNS improved child linear growth by 18 months. Mean length in the SQ-LNS group was 79.7 cm versus 79.1 cm in the iron-folic acid and multiple micronutrient groups, and the combined two-group analysis showed a 0.61 cm benefit for length (P = 0.001), a 0.20 higher LAZ (P = 0.002), a 210 g higher weight (P = 0.010), and a 16 higher WAZ (P = 0.018). Stunting was lower in the SQ-LNS group: 8.9% versus 13.7% and 12.9% in the comparison groups, with a received-enrollment analysis RR of 0.67 (95% CI: 0.46, 0.99) and P = 0.045 for prevalence across groups. Change in WLZ from birth to 18 months did…
- Study & population
- Randomized controlled trial in semi-urban Ghana among pregnant women enrolled at about 16 weeks' gestation and followed with their children through 18 months of age.
- Intervention
- The active regimen provided mothers 20-g daily small-quantity lipid-based nutrient supplement (SQ-LNS) sachets during pregnancy and the first 6 months postpartum.
- Key limitation
- The study was conducted in a single semi-urban region of Ghana, which may limit generalizability.
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Open PDFOriginal abstract
Background: Childhood stunting usually begins in utero and continues after birth; therefore, its reduction must involve actions across different stages of early life. Objective: We evaluated the efficacy of small-quantity, lipid-based nutrient supplements (SQ-LNSs) provided during pregnancy, lactation, and infancy on attained size by 18 mo of age. Design: In this partially double-blind, individually randomized trial, 1320 women at ≤20 wk of gestation received standard iron and folic acid (IFA group), multiple micronutrients (MMN group), or SQ-LNS (LNS group) daily until delivery, and then placebo, MMNs, or SQ-LNS, respectively, for 6 mo postpartum; infants in the LNS group received SQ-LNS formulated for infants from 6 to 18 mo of age (endline). The primary outcome was child length by 18 mo of age. Results: At endline, data were available for 85% of 1228 infants enrolled; overall mean length and length-for-age z score (LAZ) were 79.3 cm and −0.83, respectively, and 12% of the children were stunted (LAZ <−2). In analysis based on the intended treatment, mean ± SD length and LAZ for the LNS group (79.7 ± 2.9 cm and −0.69 ± 1.01, respectively) were significantly greater than for the IFA (79.1 ± 2.9 cm and −0.87 ± 0.99) and MMN (79.1 ± 2.9 cm and −0.91 ± 1.01) groups (P = 0.006 and P = 0.009, respectively). Differences were also significant for weight and weight-for-age z score but not head or midupper arm circumference, and the prevalence of stunting in the LNS group was 8.9%, compared with 13.7% in the IFA group and 12.9% in the MMN group (P = 0.12). In analysis based on actual supplement provided at enrollment, stunting prevalences were 8.9% compared with 15.1% and 11.5%, respectively (P = 0.045). Conclusion: Provision of SQ-LNSs to women from pregnancy to 6 mo postpartum and to their infants from 6 to 18 mo of age may increase the child’s attained length by age 18 mo in similar settings. This trial was registered at clinicaltrials.gov as NCT00970866.