Effect of Energy Dense Biscuits in Undernourished Women on Birth Weight of Their Neonates
- Conditions
- Birth Weight
- Interventions
- Other: Wheat Flour, oil, iron & Folic acidDietary Supplement: Energy dense biscuits
- Registration Number
- NCT02294240
- Lead Sponsor
- Aga Khan University
- Brief Summary
A nutrition trial which is based on the evidence that multivitamins \& micro nutrients provided during pregnancy in malnourished women will improve neonatal birth weight. There will be two arms. Arm one will provide energy dense biscuits to pregnant women with BMI \<20 \& gestational age less than 14 weeks. The other arm with same criteria will be provided with wheat flour, oil, iron \& folic acid. Neonatal birth weight is the primary outcome of interest but maternal weight gain, maternal hemoglobin \& ferritin levels and palatability of biscuits will also be assessed.
- Detailed Description
It has been realized that micronutrient deficiencies are a major determinant of intra-uterine growth retardation (IUGR) so multiple trials using micronutrient supplementation during pregnancy have been done \& shown a positive effect on birth weight.UNICEF/WHO/United Nations University(UNU) designed a new multiple micro nutrient supplement for pregnant and lactating women-the UNICEF/WHO/UNU international multiple micro nutrient preparation (UNIMMAP)-that provides the Recommended Dietary Allowance (RDA) of 15 vitamins and minerals. The benefit of this supplementation over routinely prescribed iron and folic supplementation has been proven in multiple trials. Evidence has shown reduction in low birth newborns.
This randomized controlled trial will compare the effect of calories and multiple micro nutrients provided in energy dense biscuits manufactured by EBM to malnourished pregnant women seen by AKU's Department of Paediatrics and Child Health at their Ali Akbar Shah Goth and Ibrahim Hyderi, compared to food supplementation ration of wheat and oil, plus iron and folic acid tablet supplementation.
Arm 1: Dietary supplementation with EBM biscuits containing multiple vitamins and calcium in the recommended allowance (RDA) for pregnant women Arm 2: Supplementation with Wheat flour and oil, iron and folic acid All undernourished pregnant females identified before 14 weeks of gestation through our surveillance system will be offered enrollment.
First contact: First meeting will be on enrollment. Patients will be randomized into any one of the arm. After randomization Weight, height, MUAC and BMI will be recorded. Samples for Ferritin \& hemoglobin will be drawn. In Arm 1 participant will be supplied with energy dense biscuits while in arm 2 will be provided with Wheat flour and oil after every two weeks.
End of each trimester: In second(20-22 week) \& third trimester(33-35 week) weight, MUAC \& BMI will be recorded. Supplementation will be given according to the Arm. Samples will also be drawn for Ferritin \& hemoglobin on third visit. Also at the third trimester visit palatability, accessibility and compliance with biscuits will be assessed by filling a preformed questionnaire.
Follow up of the newborn: Follow up of the newborn will be done within 48 hours. Length, weight, fronto-occipital circumference and MUAC will be recorded.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- Female
- Target Recruitment
- 224
All pregnant females with gestational age ≤14 weeks and Body mass index(BMI) <18.5
Pregnant females with underlying chronic illness (cardiovascular disease, diabetes, renal disease, and hypertension)
Pregnant females with history of multiple abortions ( two or more abortions)
Pregnant females identified as having twin/triplet pregnancies
Pregnant females not consenting to participate
Pregnant females who are already enrolled in any other study that may interfere with the results of this study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm Two Wheat Flour, oil, iron & Folic acid Wheat Flour,oil, iron and folic acid will be provided fortnightly throughout pregnancy after enrolment Arm One Energy dense biscuits Energy dense biscuits will be provided throughout pregnancy after enrolment
- Primary Outcome Measures
Name Time Method Neonatal birth weight within 48 hours of birth Newborns will be captured within 48 hours of their birth and their birthweight will be measured
- Secondary Outcome Measures
Name Time Method Maternal weight gain on enrolment,20-22 week, 33-35 week of gestation Maternal weight gain will be assessed by checking maternal weight on all three visits
Maternal Hemoglobin and Ferritin On enrollment and last visit (33-35 weeks of gestation) Maternal Hemoglobin and Ferritin will be checked by drawing blood on enrollment and on 33-35 weeks of gestation
Palatability, acceptability, and compliance of the biscuits On last visit (33-35 weeks of gestation) Palatability, acceptability, and compliance of the biscuits by filling a preformed questionnaire
Trial Locations
- Locations (2)
Ali Akbar Shah
🇵🇰Karachi, Sindh, Pakistan
Ibrahim Hyderi
🇵🇰Karachi, Sindh, Pakistan