The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth.

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  • Additional Information
    • Source:
      Publisher: American Society for Nutrition Country of Publication: United States NLM ID: 0404243 Publication Model: Print Cited Medium: Internet ISSN: 1541-6100 (Electronic) Linking ISSN: 00223166 NLM ISO Abbreviation: J. Nutr. Subsets: MEDLINE
    • Publication Information:
      Publication: : Rockville, MD : American Society for Nutrition
      Original Publication: 1928-1933 : Springfield, Ill. : C. C. Thomas
    • Subject Terms:
    • Abstract:
      Background: Maternal micronutrient supplementation in pregnancy (MMS) has been shown to improve birth weight among infants in low- and middle-income countries. Recent evidence suggests that the survival benefits of MMS are greater for female infants compared to male infants, but the mechanisms leading to differential effects remain unclear.
      Objective: The objective of this study was to examine the potential mechanisms through which MMS acts on infant mortality among Tanzanian infants.
      Methods: We used data collected from pregnant women and newborns in a randomized, double-blind, placebo-controlled trial of MMS conducted in Tanzania to examine mediators of the effect of MMS on 6-wk infant mortality (NCT00197548). Causal mediation analyses with the counterfactual approach were conducted to assess the contributions of MMS on survival via their effects on birth weight, gestational age, weight-for-gestational age, and the joint effect of gestational age and weight-for-gestational age. The weighting method allowed for interaction between gestational age and weight-for-gestational age.
      Results: Among 7486 newborns, the effect of MMS on 6-wk survival was fully mediated (100%) through the joint effect of gestational age and weight-for-gestational age. MMS was also found to have a significant natural indirect effect through increased birth weight (P-value < 0.001) that explained 75% of the total effect on 6-wk mortality. When analyses were stratified by sex, changes in gestational age and weight-for-gestational age fully mediated the mortality effect among female infants (n = 3570), but these mediators only explained 34% of the effect among males (n = 3833).
      Conclusions: The potential sex-specific effects of MMS on mortality may be a result of differences in mechanisms related to birth outcomes. In the context of the Tanzanian trial, the observed effect of MMS on 6-wk mortality for female infants was entirely mediated by increased gestation duration and improved intrauterine growth, while these mechanisms did not appear to be major contributors among male infants.
      (Copyright © American Society for Nutrition 2019.)
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    • Grant Information:
      T32 AI007358 United States AI NIAID NIH HHS
    • Contributed Indexing:
      Keywords: birth outcomes*; infant mortality*; maternal nutrition*; mediation*; multiple micronutrient supplementation*
    • Molecular Sequence:
      ClinicalTrials.gov NCT00197548
    • Accession Number:
      0 (Micronutrients)
    • Publication Date:
      Date Created: 20191013 Date Completed: 20200806 Latest Revision: 20200806
    • Publication Date:
      20200827
    • Accession Number:
      PMC7308623
    • Accession Number:
      10.1093/jn/nxz246
    • Accession Number:
      31605616
  • Citations
    • ABNT:
      QUINN, M. K. et al. The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth. The Journal of nutrition, [s. l.], v. 150, n. 2, p. 356–363, 2020. DOI 10.1093/jn/nxz246. Disponível em: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=31605616&authtype=sso&custid=s5834912. Acesso em: 30 set. 2020.
    • AMA:
      Quinn MK, Smith ER, Williams PL, et al. The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth. The Journal of nutrition. 2020;150(2):356-363. doi:10.1093/jn/nxz246
    • APA:
      Quinn, M. K., Smith, E. R., Williams, P. L., Urassa, W., Shi, J., Msamanga, G., Fawzi, W. W., & Sudfeld, C. R. (2020). The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth. The Journal of Nutrition, 150(2), 356–363. https://doi.org/10.1093/jn/nxz246
    • Chicago/Turabian: Author-Date:
      Quinn, Mary K, Emily R Smith, Paige L Williams, Willy Urassa, Joy Shi, Gernard Msamanga, Wafaie W Fawzi, and Christopher R Sudfeld. 2020. “The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth.” The Journal of Nutrition 150 (2): 356–63. doi:10.1093/jn/nxz246.
    • Harvard:
      Quinn, M. K. et al. (2020) ‘The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth’, The Journal of nutrition, 150(2), pp. 356–363. doi: 10.1093/jn/nxz246.
    • Harvard: Australian:
      Quinn, MK, Smith, ER, Williams, PL, Urassa, W, Shi, J, Msamanga, G, Fawzi, WW & Sudfeld, CR 2020, ‘The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth’, The Journal of nutrition, vol. 150, no. 2, pp. 356–363, viewed 30 September 2020, .
    • MLA:
      Quinn, Mary K., et al. “The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth.” The Journal of Nutrition, vol. 150, no. 2, Feb. 2020, pp. 356–363. EBSCOhost, doi:10.1093/jn/nxz246.
    • Chicago/Turabian: Humanities:
      Quinn, Mary K, Emily R Smith, Paige L Williams, Willy Urassa, Joy Shi, Gernard Msamanga, Wafaie W Fawzi, and Christopher R Sudfeld. “The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth.” The Journal of Nutrition 150, no. 2 (February 1, 2020): 356–63. doi:10.1093/jn/nxz246.
    • Vancouver/ICMJE:
      Quinn MK, Smith ER, Williams PL, Urassa W, Shi J, Msamanga G, et al. The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth. The Journal of nutrition [Internet]. 2020 Feb 1 [cited 2020 Sep 30];150(2):356–63. Available from: http://widgets.ebscohost.com/prod/customlink/proxify/proxify.php?count=1&encode=0&proxy=&find_1=&replace_1=&target=http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=mdc&AN=31605616&authtype=sso&custid=s5834912