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Periconceptional multiple-micronutrient supplementation and placental function in rural Gambian women: a double-blind, randomized, placebo-controlled trial

Owens, Stephen, Gulati, Ruchi, Fulford, Anthony J, Sosseh, Fatou, Denison, Fiona C, Brabin, Bernard and Prentice, Andrew M (2015) 'Periconceptional multiple-micronutrient supplementation and placental function in rural Gambian women: a double-blind, randomized, placebo-controlled trial'. American Journal of Clinical Nutrition, Vol 102, Issue 6, pp. 1450-1459.

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Abstract

Background:
Maternal micronutrient deficiencies are commonly associated with clinical indicators of placental dysfunction.

Objective:
We tested the hypothesis that periconceptional multiple-micronutrient supplementation (MMS) affects placental function.

Design:
We conducted a double-blind, randomized, placebo-controlled trial of MMS in 17- to 45-y-old Gambian women who were menstruating regularly and within the previous 3 mo. Eligible subjects were pre–randomly assigned to supplementation with the UNICEF/WHO/United Nations University multiple micronutrient preparation (UNIMMAP) or placebo on recruitment and until they reached their first antenatal check-up or for 1 y if they failed to conceive. Primary outcome measures were midgestational indexes of utero-placental vascular-endothelial function [ratio of plasminogen-activator inhibitor (PAI) 1 to PAI-2 and mean uterine-artery resistance index (UtARI)] and placental active transport capacity at delivery [fetal to maternal measles antibody (MMA) ratio].

Results:
We recruited 1156 women who yielded 415 pregnancies, of which 376 met all of the inclusion criteria. With adjustment for gestational age at sampling, there were no differences in PAI-1 to PAI-2 or MMA ratios between trial arms, but there was a 0.02-unit reduction in UtARI between 18 and 32 wk of gestation (95% CI: −0.03, −0.00; P = 0.040) in women taking UNIMMAP.

Conclusions:
Placental vascular function was modifiable by periconceptional micronutrient supplementation. However, the effect was small and supplementation did not further affect other variables of placental function. This trial was registered at www.controlled-trials.com as ISRCTN 13687662.

Item Type: Article
Subjects: QU Biochemistry > Vitamins > QU 145.5 Nutritive values of food
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.3945/ajcn.113.072413
Depositing User: Jessica Jones
Date Deposited: 04 Feb 2016 11:21
Last Modified: 06 Feb 2018 13:11
URI: https://archive.lstmed.ac.uk/id/eprint/5600

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