Micronutrients supplementation during preconception period improves fetal survival and cord blood Insulin-Like Growth Factor 1

Abstract

The objective of this study was to evaluate the efficacy of multi-micronutrients (MMN) supplementation during preconception period on improving fetal survival and concentration of umbilical cord Insulin-like Growth Factor 1 (IGF-1). A randomized double blind community based trial had been conducted. Study subjects were randomly assigned into two groups (n = 210 in each group), namely multi-micronutrient group (MMN group) and placebo-iron folic acid group (Placebo-IFA group). The MMN group received capsule of multi-micronutrients containing 15 micronutrients every 2 days during preconception period (2-6 months before pregnancy) and to be continued with daily dose during pregnancy. Placebo-IFA group received placebo capsule every 2 days during preconception period (2-6 months before pregnancy) and to be continued with daily dose of iron and folic acid during pregnancy. Four hundred twenty eligible subjects were enrolled to meet approximately 115 babies born. The outcome variables were fetal survival and concentration of serum umbilical cord IGF-1. Data were analyzed using independent t-test to compare mean difference between MMN group and Placebo-IFA group and chi-square was used for dichotomous data to analyzed odd ratio. Results demonstrated significant difference of fetal survival (gestation age >37 weeks) between MMN group and Placebo-IFA group (p = 0.003). Fetuses in MMN group were more likely to survive than those in Placebo-IFA group (OR = 6,099; 95% CI: 0.934-39.847). Despite IGF-1 concentration of umbilical cord of neonates in MMN group was higher (23.6±16.2 ng mL-1) compare to those in Placebo-IFA group (15.8±17.3 ng mL-1) but it was not different significantly (p = 0.070). Furthermore, IGF-1 concentration of umbilical cord of male neonates (18.3±12.2 ng mL-1) was lower than that of female neonates (21.5±19.9 ng mL-1). These findings imply that MMN supplementation prior to pregnancy is very important to support intra uterine environment in early pregnancy for successful complete gestation period.