Unit of Child Health and Nutrition contributes in new publication
Toe & Bouckaert, Seasonality modifies the effect of a lipid-based nutrient supplement for pregnant rural women on birth length.Maternal nutritional status is a major determinant of low birth weight and fluctuates across seasons. Hence, seasonality may influence the outcome of prenatal nutrition interventions that aim to enhance fetal growth. The overall objective of this study was to investigate seasonal modifications of the efficacy of a randomized controlled prenatal nutrition intervention trial in pregnant women to improve fetal growth in rural Burkina Faso. The MISAME2 nutrition intervention trial compared a lipid-based nutrient supplement fortified with multiple micronutrients (LNS) with a multiple micronutrient supplement (MMN). Truncated Fourier series were used to characterize seasonality in birth outcomes. Models that included the Fourier series, newborn and maternal characteristics were used to assess seasonal effect modifications of prenatal supplementation on birth outcomes. Birth weight, birth length, small-for-gestational-age as a proxy for intrauterine growth retardation, and preterm birth were significantly related to date of birth and showed important seasonal variations. LNS supplementation, which supplies energy in addition to MMN, resulted in a significant increase in birth length (+ 13.5 mm, 95% CI: 6.5, 20.5) at the transition from rain to dry season (September-November) compared to MMN alone. The climatologic and agricultural seasonal patterns in Burkina Faso affect the efficacy of prenatal LNS supplementation on birth length. In this context, prenatal MMN supplementation programs should be complemented by energy supplementation during the annual rain season to promote fetal growth. This trial was registered at clinicaltrials.gov as NCT00909974.