婴儿补铁,试试脂质营养补充剂

创作:尹洁晨 审核:Epi汪 02月01日
纳入1320名>18岁孕周≤20周的孕妇,随机分配到TFA组(孕妇补充铁和叶酸)、MMN组(孕妇补充多种微量营养素)和LNS组(孕妇及6-18个月婴儿补充脂质营养补充剂(LNS);
6个月时,三组婴儿的血红蛋白(Hb)和锌原卟啉(ZPP)浓度无差别;
18个月时,三组婴儿的Hb无差别,但LNS组中ZPP浓度低于IFA组和MMN组;
LNS组ZPP升高的患病率和贫血率均较低;
补充LNS的母婴比仅补充铁和叶酸或多种微量营养素的母亲更能提高18个月婴儿的铁含量。
延伸阅读

Maternal and Infant Supplementation with Small-Quantity Lipid-Based Nutrient Supplements Increases Infants' Iron Status at 18 Months of Age in a Semiurban Setting in Ghana: A Secondary Outcome Analysis of the iLiNS-DYAD Randomized Controlled Trial

在加纳的半城市化环境中,母亲和婴儿补充少量脂质营养补充剂可提高18个月婴儿的铁含量:一项iLiNS-DYAD随机对照试验的二次分析

01-08, Article, 10.1093/jn/nxy225more

Abstract:
Background: Interventions are needed to address iron deficiency in low-income settings.
Objective: This secondary outcome analysis aimed to compare the hemoglobin (Hb) and iron status [zinc protoporphyrin (ZPP)] of children born to women enrolled in the iLiNS-DYAD trial in Ghana.
Methods: Women ≤20 wk pregnant (n = 1320) were assigned to receive 60 mg Fe/d and 400 µg folic acid/d until delivery and placebo thereafter, and no supplementation for infants (IFA group); or multiple micronutrients containing 20 mg Fe/d until 6 mo postpartum and no supplementation for infants (MMN); or small-quantity lipid-based nutrient supplements (SQ-LNSs) containing 20 mg Fe/d until 6 mo postpartum, and SQ-LNSs for infants from 6 to 18 mo of age (LNS). We compared infants' Hb (g/L) and ZPP (µmol/mol heme) at 6 and 18 mo of age.
Results: At 6 mo of age, groups did not differ in mean ± SD Hb (overall: 113 ± 9.9 g/L) or geometric mean (95% CI) ZPP [overall: 62.6 (60.6, 64.7)]. At 18 mo of age, mean ± SD Hb (overall: 112 ± 10.4 g/L) did not differ significantly between groups, whereas geometric mean (95% CI) ZPP was lower (P = 0.031) in the LNS group [53.9 (50.7, 57.3)] than the IFA [60.4 (56.7, 64.3)] but not the MMN [58.8 (55.6, 62.2)] group. Further, the LNS group, compared with the IFA and MMN groups combined, had a lower prevalence of elevated (>70) ZPP (27.5% compared with 35%; P = 0.02) and a marginally lower prevalence of anemia (38.7% compared with 44.9%; P = 0.06). These results generally remained unchanged when controlling for prespecified covariates or correcting for inflammation.
Conclusions: In this setting, providing SQ-LNSs or multiple micronutrients with 20 mg Fe/d, compared with iron (60 mg/d) and folic acid, to pregnant women does not affect their infants' Hb or iron status at 6 mo of age, but maternal and infant supplementation with SQ-LNSs increases infants' iron status at 18 mo of age. This trial was registered at clinicaltrials.gov as NCT00970866.

First Authors:
Seth Adu-Afarwuah

Correspondence Authors:
Kathryn G Dewey

All Authors:
Seth Adu-Afarwuah,Rebecca T Young,Anna Lartey,Harriet Okronipa,Per Ashorn,Ulla Ashorn,Brietta M Oaks,Mary Arimond,Kathryn G Dewey