Effects of multiple micronutrient supplementation and pregnancy weight gain optimization
Micronutrient deficiencies among pregnant women remain highly prevalent in low and middle-income countries. Multiple micronutrient supplementation (MMS), which contains 15 vitamins and minerals, has been proven more beneficial than standard iron-folic acid supplementation in reducing adverse pregnancy outcomes. However, limited data on adherence and the effect of MMS on gestational weight gain and pregnancy outcomes in programmatic settings is available.
To address this gap, in this thesis Manti Battung of a prospective longitudinal study in the Parepare district, South Sulawesi province, Indonesia, was conducted including 1,216 participants resulting in 953 mother-infant dyads. The study found that the implementation of MMS via community health centers resulted in high adherence once supplementation started. Consuming at least 90 MMS tablets was associated with adequate gestational weight gain (GWG). Higher use of MMS also significantly reduced the risk of low birth weight and preterm birth. Additionally, the Asian body mass index (BMI) cutoff values for adequacy of GWG showed a stronger relationship between GWG adequacy and pregnancy outcomes than WHO and Indonesia BMI cutoffs, even after adjusting for the total number of MMS consumed.
Therefore, ensuring that pregnant women start consuming MMS as early as possible and continue taking MMS throughout pregnancy is key. These findings support Indonesia’s ongoing initiative to roll out MMS nationally for pregnant women. Furthermore, adopting a continuum of care approach is instrumental, as it provides a more comprehensive, integrated, and continuous system of care throughout this critical period of life, including the preconception period, pregnancy, childbirth, and early childhood, ultimately benefiting maternal and child health.
