Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi: a secondary outcome analysis of the iLiNS DYAD trial

Seth Adu-Afarwuah; Charles D Arnold; Kenneth Maleta; Per Ashorn; Ulla Ashorn; Josh M Jorgensen; Yue-Mei Fan; Minyanga Nkhoma; Jaden Bendabenda; Andrew Matchado; Kathryn G Dewey

doi:10.1017/S1368980020003250

Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi: a secondary outcome analysis of the iLiNS DYAD trial

Seth Adu-Afarwuah, Charles D Arnold, Kenneth Maleta, Per Ashorn, Ulla Ashorn, Josh M Jorgensen, Yue-Mei Fan, Minyanga Nkhoma, Jaden Bendabenda, Andrew Matchado, Kathryn G Dewey

Terveystieteet

Tutkimustuotos: Artikkeli › Tieteellinen › vertaisarvioitu

2 Sitaatiot (Scopus)

16 Lataukset (Pure)

Abstrakti

OBJECTIVES: Inadequate iodine intake during pregnancy increases the risk of neonatal morbidity and mortality. We aimed to evaluate whether prenatal supplements containing iodine affect urinary iodine concentrations (UIC) of pregnant women in Malawi.

DESIGN: A randomised controlled trial. Pregnant women (n 1391) were assigned to consume 60 mg/d Fe and 400 µg/d folic acid (IFA) or 18 vitamins and minerals including 250 µg/d iodine (MMN) or 20 g/d small-quantity lipid-based nutrient supplements (SQ-LNS) with similar nutrient contents as MMN group, plus macronutrients (LNS) until childbirth. In a sub-study (n 317), we evaluated group geometric mean urinary iodine concentration (UIC) (µg/L) at 36 weeks of gestation controlling for baseline UIC and compared median (baseline) and geometric mean (36 weeks) UIC with WHO cut-offs: UIC < 150, 150-249, 250-499 and ≥500 reflecting insufficient, adequate, above requirements and excessive iodine intakes, respectively.

SETTING: Mangochi District, Malawi.

PARTICIPANTS: Women ≤20 weeks pregnant.

RESULTS: Groups had comparable background characteristics. At baseline, overall median (Q1, Q3) UIC (319 (167, 559)) suggested iodine intakes above requirements. At 36 weeks, the geometric mean (95 % CI) UIC of the IFA (197 (171, 226)), MMN (212 (185, 243)) and LNS (220 (192, 253)) groups did not differ (P = 0·53) and reflected adequate intakes.

CONCLUSIONS: In this setting, provision of supplements containing iodine at the recommended dose to pregnant women with relatively high iodine intakes at baseline, presumably from iodised salt, has no impact on the women's UIC. Regular monitoring of the iodine status of pregnant women in such settings is advisable. Clinicaltrials.gov identifier: NCT01239693.

Alkuperäiskieli	Englanti
Sivut	3049-3057
Sivumäärä	9
Julkaisu	PUBLIC HEALTH NUTRITION
Vuosikerta	24
Numero	10
Varhainen verkossa julkaisun päivämäärä	15 lokak. 2020
DOI - pysyväislinkit	https://doi.org/10.1017/S1368980020003250
Tila	Julkaistu - 2021
OKM-julkaisutyyppi	A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Julkaisufoorumi-taso

Jufo-taso 1

Pääsy asiakirjaan

10.1017/S1368980020003250Lisenssi: CC BY

consumption-of-multiple-micronutrients-or-small-quantity-lipid-based-nutrient-supplements-containing-iodine-at-the-recommended-dose-during-pregnancy-compared-with-iron-and-folic-acid-does-not-affect-wFinal published version, 344 KBLisenssi: CC BY

http://urn.fi/URN:NBN:fi:tuni-202101181404Lisenssi: CC BY

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Siteeraa tätä

Adu-Afarwuah, S., Arnold, C. D., Maleta, K., Ashorn, P., Ashorn, U., Jorgensen, J. M., Fan, Y.-M., Nkhoma, M., Bendabenda, J., Matchado, A., & Dewey, K. G. (2021). Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi: a secondary outcome analysis of the iLiNS DYAD trial. PUBLIC HEALTH NUTRITION, 24(10), 3049-3057. https://doi.org/10.1017/S1368980020003250

Adu-Afarwuah, Seth ; Arnold, Charles D ; Maleta, Kenneth et al. / Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi : a secondary outcome analysis of the iLiNS DYAD trial. Julkaisussa: PUBLIC HEALTH NUTRITION. 2021 ; Vuosikerta 24, Nro 10. Sivut 3049-3057.

@article{6ba6901f649847428beaadb2714d7061,

title = "Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi: a secondary outcome analysis of the iLiNS DYAD trial",

abstract = "OBJECTIVES: Inadequate iodine intake during pregnancy increases the risk of neonatal morbidity and mortality. We aimed to evaluate whether prenatal supplements containing iodine affect urinary iodine concentrations (UIC) of pregnant women in Malawi.DESIGN: A randomised controlled trial. Pregnant women (n 1391) were assigned to consume 60 mg/d Fe and 400 µg/d folic acid (IFA) or 18 vitamins and minerals including 250 µg/d iodine (MMN) or 20 g/d small-quantity lipid-based nutrient supplements (SQ-LNS) with similar nutrient contents as MMN group, plus macronutrients (LNS) until childbirth. In a sub-study (n 317), we evaluated group geometric mean urinary iodine concentration (UIC) (µg/L) at 36 weeks of gestation controlling for baseline UIC and compared median (baseline) and geometric mean (36 weeks) UIC with WHO cut-offs: UIC < 150, 150-249, 250-499 and ≥500 reflecting insufficient, adequate, above requirements and excessive iodine intakes, respectively.SETTING: Mangochi District, Malawi.PARTICIPANTS: Women ≤20 weeks pregnant.RESULTS: Groups had comparable background characteristics. At baseline, overall median (Q1, Q3) UIC (319 (167, 559)) suggested iodine intakes above requirements. At 36 weeks, the geometric mean (95 % CI) UIC of the IFA (197 (171, 226)), MMN (212 (185, 243)) and LNS (220 (192, 253)) groups did not differ (P = 0·53) and reflected adequate intakes.CONCLUSIONS: In this setting, provision of supplements containing iodine at the recommended dose to pregnant women with relatively high iodine intakes at baseline, presumably from iodised salt, has no impact on the women's UIC. Regular monitoring of the iodine status of pregnant women in such settings is advisable. Clinicaltrials.gov identifier: NCT01239693.",

author = "Seth Adu-Afarwuah and Arnold, {Charles D} and Kenneth Maleta and Per Ashorn and Ulla Ashorn and Jorgensen, {Josh M} and Yue-Mei Fan and Minyanga Nkhoma and Jaden Bendabenda and Andrew Matchado and Dewey, {Kathryn G}",

year = "2021",

doi = "10.1017/S1368980020003250",

language = "English",

volume = "24",

pages = "3049--3057",

journal = "PUBLIC HEALTH NUTRITION",

issn = "1368-9800",

publisher = "Cambridge University Press",

number = "10",

}

Adu-Afarwuah, S, Arnold, CD, Maleta, K, Ashorn, P , Ashorn, U, Jorgensen, JM, Fan, Y-M, Nkhoma, M, Bendabenda, J, Matchado, A & Dewey, KG 2021, 'Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi: a secondary outcome analysis of the iLiNS DYAD trial', PUBLIC HEALTH NUTRITION, Vuosikerta 24, Nro 10, Sivut 3049-3057. https://doi.org/10.1017/S1368980020003250

Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi: a secondary outcome analysis of the iLiNS DYAD trial. / Adu-Afarwuah, Seth; Arnold, Charles D; Maleta, Kenneth et al.
julkaisussa: PUBLIC HEALTH NUTRITION, Vuosikerta 24, Nro 10, 2021, s. 3049-3057.

Tutkimustuotos: Artikkeli › Tieteellinen › vertaisarvioitu

TY - JOUR

T1 - Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi

T2 - a secondary outcome analysis of the iLiNS DYAD trial

AU - Adu-Afarwuah, Seth

AU - Arnold, Charles D

AU - Maleta, Kenneth

AU - Ashorn, Per

AU - Ashorn, Ulla

AU - Jorgensen, Josh M

AU - Fan, Yue-Mei

AU - Nkhoma, Minyanga

AU - Bendabenda, Jaden

AU - Matchado, Andrew

AU - Dewey, Kathryn G

PY - 2021

Y1 - 2021

N2 - OBJECTIVES: Inadequate iodine intake during pregnancy increases the risk of neonatal morbidity and mortality. We aimed to evaluate whether prenatal supplements containing iodine affect urinary iodine concentrations (UIC) of pregnant women in Malawi.DESIGN: A randomised controlled trial. Pregnant women (n 1391) were assigned to consume 60 mg/d Fe and 400 µg/d folic acid (IFA) or 18 vitamins and minerals including 250 µg/d iodine (MMN) or 20 g/d small-quantity lipid-based nutrient supplements (SQ-LNS) with similar nutrient contents as MMN group, plus macronutrients (LNS) until childbirth. In a sub-study (n 317), we evaluated group geometric mean urinary iodine concentration (UIC) (µg/L) at 36 weeks of gestation controlling for baseline UIC and compared median (baseline) and geometric mean (36 weeks) UIC with WHO cut-offs: UIC < 150, 150-249, 250-499 and ≥500 reflecting insufficient, adequate, above requirements and excessive iodine intakes, respectively.SETTING: Mangochi District, Malawi.PARTICIPANTS: Women ≤20 weeks pregnant.RESULTS: Groups had comparable background characteristics. At baseline, overall median (Q1, Q3) UIC (319 (167, 559)) suggested iodine intakes above requirements. At 36 weeks, the geometric mean (95 % CI) UIC of the IFA (197 (171, 226)), MMN (212 (185, 243)) and LNS (220 (192, 253)) groups did not differ (P = 0·53) and reflected adequate intakes.CONCLUSIONS: In this setting, provision of supplements containing iodine at the recommended dose to pregnant women with relatively high iodine intakes at baseline, presumably from iodised salt, has no impact on the women's UIC. Regular monitoring of the iodine status of pregnant women in such settings is advisable. Clinicaltrials.gov identifier: NCT01239693.

AB - OBJECTIVES: Inadequate iodine intake during pregnancy increases the risk of neonatal morbidity and mortality. We aimed to evaluate whether prenatal supplements containing iodine affect urinary iodine concentrations (UIC) of pregnant women in Malawi.DESIGN: A randomised controlled trial. Pregnant women (n 1391) were assigned to consume 60 mg/d Fe and 400 µg/d folic acid (IFA) or 18 vitamins and minerals including 250 µg/d iodine (MMN) or 20 g/d small-quantity lipid-based nutrient supplements (SQ-LNS) with similar nutrient contents as MMN group, plus macronutrients (LNS) until childbirth. In a sub-study (n 317), we evaluated group geometric mean urinary iodine concentration (UIC) (µg/L) at 36 weeks of gestation controlling for baseline UIC and compared median (baseline) and geometric mean (36 weeks) UIC with WHO cut-offs: UIC < 150, 150-249, 250-499 and ≥500 reflecting insufficient, adequate, above requirements and excessive iodine intakes, respectively.SETTING: Mangochi District, Malawi.PARTICIPANTS: Women ≤20 weeks pregnant.RESULTS: Groups had comparable background characteristics. At baseline, overall median (Q1, Q3) UIC (319 (167, 559)) suggested iodine intakes above requirements. At 36 weeks, the geometric mean (95 % CI) UIC of the IFA (197 (171, 226)), MMN (212 (185, 243)) and LNS (220 (192, 253)) groups did not differ (P = 0·53) and reflected adequate intakes.CONCLUSIONS: In this setting, provision of supplements containing iodine at the recommended dose to pregnant women with relatively high iodine intakes at baseline, presumably from iodised salt, has no impact on the women's UIC. Regular monitoring of the iodine status of pregnant women in such settings is advisable. Clinicaltrials.gov identifier: NCT01239693.

U2 - 10.1017/S1368980020003250

DO - 10.1017/S1368980020003250

M3 - Article

C2 - 33054890

SN - 1368-9800

VL - 24

SP - 3049

EP - 3057

JO - PUBLIC HEALTH NUTRITION

JF - PUBLIC HEALTH NUTRITION

IS - 10

ER -

Adu-Afarwuah S, Arnold CD, Maleta K, Ashorn P , Ashorn U, Jorgensen JM et al. Consumption of multiple micronutrients or small-quantity lipid-based nutrient supplements containing iodine at the recommended dose during pregnancy, compared with iron and folic acid, does not affect women's urinary iodine concentration in rural Malawi: a secondary outcome analysis of the iLiNS DYAD trial. PUBLIC HEALTH NUTRITION. 2021;24(10):3049-3057. Epub 2020 loka 15. doi: 10.1017/S1368980020003250