SUPPLEMENTATION IN PRIMI-GRAVIDAS AND ITS EFFECT ON MATERNAL, BIRTH AND INFANT OUTCOMES: A RANDOMIZED CONTROLLED TRIAL

Abstract

OBJECTIVE: To find out the effect of Lipid based nutritional supplement (LNS) on body composition, hematological findings, maternal, birth and infant outcomes in underweight primi-gravidas. METHODS: This single-blinded randomized controlled clinical trial was executed in the tertiary care hospitals of Khyber Pakhtunkhwa province, Pakistan from April 2018 to August 2019. Forty primi-gravidas recruited in the study were randomized into LNS and placebo groups. LNS group received 75 gms of high energy nutritional supplement, named “MAAMTA”, on daily basis from their first antenatal visit till delivery in addition to their conventional antenatal treatment. Fasting blood samples were taken and body composition was measured at baseline visit, 16th week of gestation and post-natally. For the measurement of hematological parameters neonates cord blood was obtained. Data of 36 participants (LNS group n=19; placebo group n=17) were available for final analysis. RESULTS: Majority (n=33/36; 91.7%) had normal vaginal deliveries (n=18/19 in LNS group & n=15/17 in placebo group). Frequency of Cesarean section was 1/19 (5.3%) in LNS group and 2/17 (11.8%) in placebo group. No case of abortion was reported. Mean crown heel length (CHL) was 47.11±2.747 cm in LNS group and 44.24±2.359 cm in placebo group (p=0.002). Mean frontooccipital circumference was 35.11±1.663 cm and 32.41±7.859 cm in the LNS and placebo groups respectively (p=0.153). No difference was observed between the groups in maternal gestational weight gain per visit, prevalence of maternal anemia, maternal mortality & neonatal birth weight. CONCLUSION: The prenatal use of LNS increases the CHL of the neonates of underweight primi-gravidas.