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.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308623 | PMC |
| http://dx.doi.org/10.1093/jn/nxz246 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Risk Factors in Addition to Short and Long-Term Outcomes With Thin Catheter Surfactant Administration Failure in Preterm Infants: A Retrospective Analysis.
J Paediatr Child Health
January 2025
Department of Neonatology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey.
Objective: To evaluate the incidence of thin catheter surfactant administration (TCA) failure and compare short and long-term neonatal outcomes who failed TCA or did not.
Design: Single-center retrospective cohort study. Infants between 25 and 30 weeks of gestational age with respiratory distress syndrome and receiving 200 mg/kg poractant alfa via thin catheter administration were included.
Transition to competent oral feeding in preterm infants: Analyzing timing and determinants.
An Pediatr (Engl Ed)
January 2025
Departamento de Enfermería, Unidad de Neonatología, Hospital Universitario de Burgos, Burgos, Spain.
Introduction: The achievement of oral feeding competence (OFC) is a challenge in preterm infants and can be affected by several factors.
Objective: The aim of our study was to determine the time elapsed to development of OFC in very low birth weight (VLBW, weight <1500g) preterm infants and to identify factors associated with greater difficulty in achieving this skill.
Population And Methods: Observational, longitudinal and prospective study in VLBW infants over a period of 7 years (2016-2022).
Outcomes of Extremely Preterm Infants Exposed to Prolonged Prelabor Rupture of Membranes before 24 Weeks of Gestation.
Am J Obstet Gynecol
January 2025
Department of Pediatrics, Duke University School of Medicine, Durham, NC.
Background: Preterm prelabor rupture of membranes (PPROM) before or around the limit of fetal viability is associated with serious maternal and neonatal complications including chorioamnionitis, extremely preterm birth, and pulmonary hypoplasia.
Objectives: To describe contemporary outcomes of extremely preterm infants born after prolonged periviable PPROM, and to identify perinatal factors associated with survival and survival without severe neurodevelopmental impairment (NDI).
Study Design: Among actively treated infants born alive at <27 weeks' gestational age (GA) in centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network from 2012 to 2018, the outcomes of survival and survival without severe NDI at 22-26 months' corrected age were compared between infants exposed to prolonged (≥120 hours) periviable (<24 weeks' GA) PPROM and unexposed infants born after rupture of membranes ≤18 hours before delivery or at delivery, adjusting for birth GA, sex, multiple gestation, antenatal steroids, small for gestational age (SGA), insurance, and center.
The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth.
BMC Pregnancy Childbirth
January 2025
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Background: Inadequate and excessive gestational weight gain (GWG) defined by the Institute of Medicine (IOM) has been associated with preterm birth. However, studies demonstrate inconsistent associations.
Objectives: We examined the associations between categorical and continuous total GWG and moderate to late preterm birth (32-<37 weeks), and evaluated differences in these associations by pre-pregnancy BMI.
A cross-sectional study on posttraumatic growth and influencing factors among parents of premature infants.
BMC Pregnancy Childbirth
January 2025
Nursing Department, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, 518026, China.
Article Synopsis
- Preterm birth significantly impacts parents' mental health, and posttraumatic growth (PTG) can help them cope with this trauma, though research on PTG in this context is limited.
- A study involving 160 parents in Shenzhen, China, found that most had low to medium PTG levels, with influences like older gestational age, higher Apgar scores, positive coping styles, and better social support correlating with higher PTG.
- The findings highlight the importance of social support and effective coping mechanisms in fostering PTG among parents dealing with the challenges of having a preterm infant.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!