Maternal Blood Pressure in Relation to Prenatal Lipid-Based Nutrient Supplementation and Adverse Birth Outcomes in a Ghanaian Cohort: A Randomized Controlled Trial and Cohort Analysis

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dc.contributor.authorAbreu, A.M.
dc.contributor.authorYoung, R.R.
dc.contributor.authorBuchanan, A.
dc.contributor.authorLofgren, I.E.
dc.contributor.authorOkronipa, H.E.T.
dc.contributor.authorLartey, A.
dc.contributor.authorAshorn, P.
dc.contributor.authorAdu-Afarwuah, S.
dc.contributor.authorDewey, K.G.
dc.contributor.authorOaks, B.M.
dc.date.accessioned2021-12-14T16:24:06Z
dc.date.available2021-12-14T16:24:06Z
dc.date.issued2021
dc.descriptionResearch Articleen_US
dc.description.abstractBackground: It is unknown whether prenatal lipid-based nutrient supplements (LNSs) affect blood pressure (BP). Associations between hypertension and birth outcomes using recently updated BP cutoffs are undetermined. Objectives: We aimed to assess the impact of LNSs on maternal hypertension and associations between hypertension and birth outcomes. Methods: Pregnant Ghanaian women at ≤20 weeks of gestation (n = 1320) were randomly assigned to receive daily 1) iron and folic acid (IFA), 2) multiple micronutrients (MMN), or 3) LNSs until delivery. BP was measured at enrollment and 36 weeks of gestation. We analyzed the effect of LNSs on BP using ANOVA and associations between hypertension [systolic BP (SBP) ≥130 mm Hg or diastolic BP (DBP) ≥80 mm Hg] and birth outcomes by linear and logistic regressions. Results: Mean ± SD SBP and DBP were 110 ± 11 and 63 ± 8 mm Hg at 36 weeks of gestation and did not differ by supplementation group (SBP, P > 0.05; DBP, P > 0.05). At enrollment, higher DBP was associated with lower birth weight and shorter gestation; women with high DBP had greater risk of low birth weight (LBW) [risk ratio (RR): 2.58; 95% CI: 1.09, 6.08] and preterm birth (PTB) (RR: 3.30; 95% CI: 1.47, 7.40). At 36 weeks of gestation, higher SBP was associated with lower birth weight, length, and head circumference and shorter gestation; higher DBP was associated with lower birth weight and length; and women with high DBP had greater risk of LBW (RR: 3.39; 95% CI: 1.32, 8.69). Neither high SBP nor hypertension were associated with birth outcomes at either time point. Conclusions: Daily provision of LNSs does not affect maternal hypertension, compared with IFA and MMN. Higher SBP and DBP are associated with a shorter gestation and smaller birth size; however, only high DBP is associated with LBW and PTB. The new BP cutoffs may help identify pregnancies at risk of adverse birth outcomes.en_US
dc.identifier.otherhttps://doi.org/10.1093/jn/nxab018.
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/37286
dc.language.isoen_USen_US
dc.publisherASNen_US
dc.subjectbirth outcomesen_US
dc.subjectGhanaen_US
dc.subjectmaternal blood pressureen_US
dc.subjectprenatal supplementsen_US
dc.subjectmaternal hypertensionen_US
dc.subjectlow birth weighten_US
dc.subjectpreterm birthen_US
dc.titleMaternal Blood Pressure in Relation to Prenatal Lipid-Based Nutrient Supplementation and Adverse Birth Outcomes in a Ghanaian Cohort: A Randomized Controlled Trial and Cohort Analysisen_US
dc.typeArticleen_US

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