Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15–24 years): a prospective, population-based cluster-randomized trial
Background Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide...
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| Vydané v: | Reproductive health Ročník 15; číslo 1; s. 104 - 13 |
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| Hlavní autori: | , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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London
BioMed Central
31.05.2018
BioMed Central Ltd Springer Nature B.V BMC |
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| ISSN: | 1742-4755, 1742-4755 |
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| Abstract | Background
Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one’s own well-being, as well as future pregnancy outcomes and the health of the next generation.
Methods
The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15–24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality.
Discussion
Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception.
Trial registration
The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier:
NCT03287882
) on September 19, 2017. |
|---|---|
| AbstractList | Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation.BACKGROUNDRisk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation.The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality.METHODSThe Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality.Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception.DISCUSSIONPreconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception.The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882 ) on September 19, 2017.TRIAL REGISTRATIONThe MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882 ) on September 19, 2017. Background Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one’s own well-being, as well as future pregnancy outcomes and the health of the next generation. Methods The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15–24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Discussion Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception. Trial registration The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882) on September 19, 2017. Background Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation. Methods The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Discussion Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception. Trial registration The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882) on September 19, 2017. Keywords: Adolescence, Young adult, Nutrition, Micronutrients, Education, Preconception, Low birth weight, Pregnancy, Empowerment Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation. The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception. Abstract Background Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one’s own well-being, as well as future pregnancy outcomes and the health of the next generation. Methods The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15–24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Discussion Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception. Trial registration The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882) on September 19, 2017. Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation. The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception. The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882 ) on September 19, 2017. Background Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one’s own well-being, as well as future pregnancy outcomes and the health of the next generation. Methods The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15–24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Discussion Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception. Trial registration The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882 ) on September 19, 2017. |
| ArticleNumber | 104 |
| Audience | Academic |
| Author | Wasan, Yaqub Soofi, Sajid B. Suhag, Zamir Baxter, Jo-Anna B. Bhutta, Zulfiqar A. |
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| PublicationTitle | Reproductive health |
| PublicationTitleAbbrev | Reprod Health |
| PublicationTitleAlternate | Reprod Health |
| PublicationYear | 2018 |
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| References_xml | – volume: 14 start-page: 111 year: 2014 ident: 545_CR17 publication-title: BMC Pregnancy and Childbirth doi: 10.1186/1471-2393-14-111 – volume: 146 start-page: 1445S issue: 7 year: 2016 ident: 545_CR19 publication-title: J Nutr doi: 10.3945/jn.115.223420 – volume-title: Pakistan's Lady Health Worker Programme: Global Health Workforce Alliance, World Health Organization, Case study year: 2008 ident: 545_CR24 – volume-title: Household food insecurity access scale (HFIAS) for measurement of household food access: Indicator guide (v. 3) year: 2007 ident: 545_CR30 – volume: 150 start-page: 782 year: 1987 ident: 545_CR28 publication-title: Br J Psychiatry doi: 10.1192/bjp.150.6.782 – start-page: 35 volume-title: Measures in health psychology: a user’s portfolio. Causal and control beliefs year: 1995 ident: 545_CR33 – volume-title: Government of Pakistan year: 2013 ident: 545_CR22 – volume: 382 start-page: 452 issue: 9890 year: 2013 ident: 545_CR6 publication-title: Lancet doi: 10.1016/S0140-6736(13)60996-4 – volume: 5 start-page: e1090 issue: 11 year: 2017 ident: 545_CR13 publication-title: Lancet Glob Health doi: 10.1016/S2214-109X(17)30371-6 – volume: 97 start-page: 911 issue: 5 year: 2013 ident: 545_CR1 publication-title: Am J Clin Nutr doi: 10.3945/ajcn.112.052332 – volume-title: Health Behaviour in School-aged Children (HBSC) Study Protocol: Background, Methodology, and Mandatory items for the 2013/14 Survey year: 2014 ident: 545_CR31 – volume-title: The social psychology of health: Claremont Symposium on applied social psychology year: 1988 ident: 545_CR34 – volume-title: United Nations University. Composition of a multi-micronutrient supplement to be used in pilot programmes among pregnant women in developing countries year: 1999 ident: 545_CR27 – volume: 346 start-page: e7586 year: 2013 ident: 545_CR20 publication-title: BMJ doi: 10.1136/bmj.e7586 – volume: 121 start-page: 40 issue: Suppl 1 year: 2014 ident: 545_CR2 publication-title: BJOG doi: 10.1111/1471-0528.12630 – volume: 382 start-page: 427 issue: 9890 year: 2013 ident: 545_CR8 publication-title: Lancet doi: 10.1016/S0140-6736(13)60937-X – volume: 120 start-page: 42 issue: Suppl 2 year: 2013 ident: 545_CR29 publication-title: BJOG doi: 10.1111/1471-0528.12125 – volume: 52 start-page: 30 year: 1988 ident: 545_CR32 publication-title: J Pers Assess doi: 10.1207/s15327752jpa5201_2 – volume: 11 start-page: S2 issue: Suppl 3 year: 2014 ident: 545_CR14 publication-title: Reprod Health doi: 10.1186/1742-4755-11-S3-S2 – volume: 33 start-page: 70 year: 2001 ident: 545_CR3 publication-title: Fam Plan Perspect doi: 10.2307/2673752 – volume: 61 start-page: 210 year: 2011 ident: 545_CR25 publication-title: J Pak Med Assoc – volume: 26 start-page: 285 issue: Suppl 1 year: 2012 ident: 545_CR11 publication-title: Paediatr Perinat Epidemiol doi: 10.1111/j.1365-3016.2012.01281.x – volume: 100 start-page: 1257 issue: 5 year: 2014 ident: 545_CR16 publication-title: Am J Clin Nutr doi: 10.3945/ajcn.114.084921 – ident: 545_CR21 doi: 10.1186/s12978-018-0547-y – volume: 41 start-page: 75 year: 1979 ident: 545_CR36 publication-title: J Marriage Fam doi: 10.2307/351733 – volume: 16 start-page: 80 issue: 1 year: 2010 ident: 545_CR7 publication-title: Hum Reprod Update doi: 10.1093/humupd/dmp025 – volume: 102 start-page: 1450 issue: 6 year: 2015 ident: 545_CR18 publication-title: Am J Clin Nutr doi: 10.3945/ajcn.113.072413 – volume-title: Manual for the Depression Anxiety Stress Scales year: 1995 ident: 545_CR35 – volume-title: WHO guidelines on preventing early pregnancy and poor reproductive health outcomes among adolescents in developing countries year: 2011 ident: 545_CR5 – volume-title: Adolescent pregnancy: unmet needs and undone deeds: a review of the literature and programmes year: 2007 ident: 545_CR4 – volume-title: Pakistan Demographic and Health Survey 2012–13 year: 2013 ident: 545_CR23 – volume-title: Daily iron and folic acid supplementation in pregnant women: guideline year: 2012 ident: 545_CR26 – volume: 12 start-page: CD007950 year: 2015 ident: 545_CR9 publication-title: Cochrane Database Syst Rev – volume-title: WHO recommendations on antenatal Care for a Positive Pregnancy Experience year: 2016 ident: 545_CR10 – volume: 4 start-page: CD004905 year: 2017 ident: 545_CR12 publication-title: Cochrane Database Syst Rev – volume: 11 start-page: S3 issue: Suppl 3 year: 2014 ident: 545_CR15 publication-title: Reprod Health doi: 10.1186/1742-4755-11-S3-S3 |
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Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes... Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her... Background Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes... Abstract Background Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl... |
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| SubjectTerms | Adolescence Adolescent Adult Analysis Anemia Anthropometry Birth weight Births Child development Clinical trials Dietary Supplements Education Empowerment Evidence-based medicine Female Food and nutrition Global health Health aspects Health Education Humans Infant, Low Birth Weight Intervention Life skills Life Style Low income groups Malnutrition Maternal and Child Health Medicine Medicine & Public Health Micronutrients Micronutrients - administration & dosage Mother-infant relations Nutrition Pakistan - epidemiology Patient education Preconception Preconception Care - methods Pregnancy Pregnancy Complications - epidemiology Pregnancy Complications - therapy Pregnancy Outcome Pregnant women Prospective Studies Public Health Reproductive health Reproductive Medicine Rural Population Standard of care Standard of Care - statistics & numerical data Study Protocol Teenage pregnancy Teenagers Vitamin B Well being Womens health Young Adult Young adults |
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| Title | Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15–24 years): a prospective, population-based cluster-randomized trial |
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