Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood: follow-up of a double-blind randomised controlled trial in Nepal

Delan Devakumar, Janet Stocks, Jon G Ayres, Jane Kirby, Sushil K Yadav, Naomi M Saville, Graham Devereux, Jonathan C K Wells, Dharma S Manandhar, Anthony Costello, David Osrin

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Abstract

A randomised trial of prenatal multiple micronutrient supplementation in Nepalese women increased birthweight and weight at two years of age in offspring, compared with those born to mothers who only received iron and folic acid supplements. Further follow-up of this cohort provided an opportunity to investigate the effect of antenatal multiple micronutrients on subsequent lung function, by measuring spirometry at 7-9 years of age in children born in the trial.
841 children (80% of the cohort) were seen at mean (SD) 8.5 (0.4) years. Technically successful spirometry results were obtained in 793 children (94.3%), 50% of whom had been randomised to micronutrient supplementation. Background characteristics, including anthropometry and exposures were similar in the two allocation groups. Lung function was also similar, mean (95%CI) difference in z-scores (supplementation – control) being -0.08 (-0.19, 0.04) for FEV1; -0.05 (-0.17, 0.06) for FVC and -0.04 (-0.15, 0.07) for FEV1/FVC. Compared with healthy White children, FEV1 and FVC in the ‘healthy’ Nepalese children were ~1 z-score (~13%) lower, with no difference in FEV1/FVC.
We conclude that, compared with routine iron and folic acid, multiple micronutrient supplementation during pregnancy has no effect on spirometric lung function in Nepalese children at 8.5 years of age.
Original languageEnglish
Pages (from-to)1566-1575
Number of pages10
JournalEuropean Respiratory Journal
Volume45
Issue number6
Early online date31 May 2015
DOIs
Publication statusPublished - 1 Jun 2015

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Nepal
Micronutrients
Randomized Controlled Trials
Lung
Spirometry
Folic Acid
Iron
Anthropometry
Mothers
Weights and Measures
Pregnancy

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Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood : follow-up of a double-blind randomised controlled trial in Nepal. / Devakumar, Delan; Stocks, Janet; Ayres, Jon G; Kirby, Jane; Yadav, Sushil K ; Saville, Naomi M ; Devereux, Graham; Wells, Jonathan C K; Manandhar, Dharma S; Costello, Anthony; Osrin, David.

In: European Respiratory Journal, Vol. 45, No. 6, 01.06.2015, p. 1566-1575.

Research output: Contribution to journalArticle

Devakumar, D, Stocks, J, Ayres, JG, Kirby, J, Yadav, SK, Saville, NM, Devereux, G, Wells, JCK, Manandhar, DS, Costello, A & Osrin, D 2015, 'Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood: follow-up of a double-blind randomised controlled trial in Nepal', European Respiratory Journal, vol. 45, no. 6, pp. 1566-1575. https://doi.org/10.1183/09031936.00188914
Devakumar, Delan ; Stocks, Janet ; Ayres, Jon G ; Kirby, Jane ; Yadav, Sushil K ; Saville, Naomi M ; Devereux, Graham ; Wells, Jonathan C K ; Manandhar, Dharma S ; Costello, Anthony ; Osrin, David. / Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood : follow-up of a double-blind randomised controlled trial in Nepal. In: European Respiratory Journal. 2015 ; Vol. 45, No. 6. pp. 1566-1575.
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abstract = "A randomised trial of prenatal multiple micronutrient supplementation in Nepalese women increased birthweight and weight at two years of age in offspring, compared with those born to mothers who only received iron and folic acid supplements. Further follow-up of this cohort provided an opportunity to investigate the effect of antenatal multiple micronutrients on subsequent lung function, by measuring spirometry at 7-9 years of age in children born in the trial. 841 children (80{\%} of the cohort) were seen at mean (SD) 8.5 (0.4) years. Technically successful spirometry results were obtained in 793 children (94.3{\%}), 50{\%} of whom had been randomised to micronutrient supplementation. Background characteristics, including anthropometry and exposures were similar in the two allocation groups. Lung function was also similar, mean (95{\%}CI) difference in z-scores (supplementation – control) being -0.08 (-0.19, 0.04) for FEV1; -0.05 (-0.17, 0.06) for FVC and -0.04 (-0.15, 0.07) for FEV1/FVC. Compared with healthy White children, FEV1 and FVC in the ‘healthy’ Nepalese children were ~1 z-score (~13{\%}) lower, with no difference in FEV1/FVC. We conclude that, compared with routine iron and folic acid, multiple micronutrient supplementation during pregnancy has no effect on spirometric lung function in Nepalese children at 8.5 years of age.",
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AU - Kirby, Jane

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AU - Costello, Anthony

AU - Osrin, David

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N2 - A randomised trial of prenatal multiple micronutrient supplementation in Nepalese women increased birthweight and weight at two years of age in offspring, compared with those born to mothers who only received iron and folic acid supplements. Further follow-up of this cohort provided an opportunity to investigate the effect of antenatal multiple micronutrients on subsequent lung function, by measuring spirometry at 7-9 years of age in children born in the trial. 841 children (80% of the cohort) were seen at mean (SD) 8.5 (0.4) years. Technically successful spirometry results were obtained in 793 children (94.3%), 50% of whom had been randomised to micronutrient supplementation. Background characteristics, including anthropometry and exposures were similar in the two allocation groups. Lung function was also similar, mean (95%CI) difference in z-scores (supplementation – control) being -0.08 (-0.19, 0.04) for FEV1; -0.05 (-0.17, 0.06) for FVC and -0.04 (-0.15, 0.07) for FEV1/FVC. Compared with healthy White children, FEV1 and FVC in the ‘healthy’ Nepalese children were ~1 z-score (~13%) lower, with no difference in FEV1/FVC. We conclude that, compared with routine iron and folic acid, multiple micronutrient supplementation during pregnancy has no effect on spirometric lung function in Nepalese children at 8.5 years of age.

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