Tidig utveckling och senare hälsa: Möjligheter att förebygga senare ohälsa redan under graviditeten? Uppföljning av MINIMat projektet i Bangladesh upp till 10 års ålder.
Tidsperiod: 2013-01-01 till 2015-12-31
Budget: 5 250 000 SEK
This project - follow-up of the MINIMat trial - is implemented in Bangladesh, in a context, where food insecurity and maternal malnutrition still prevail, but where changing lifestyles and economic growth potentially increase the risk for future chronic disease of the offspring. Pregnant women were randomised to an early (E) start of prenatal food supplementation vs. usual program start, and multiple micronutrient supplementation (MMS) vs. iron-folate. Participants were followed-up for primary outcomes (maternal haemoglobin, birth weight, and infant survival) and for a series of secondary outcomes based on the Developmental Origin of Health and Disease hypothesis. So far we have demonstrated a remarkable effect of E-MMS on infant and under-five survival, and effects of the interventions on childhood stunting and metabolic markers at 4.5 years. We aim at studying whether the effects of the prenatal interventions on growth and metabolic markers up to 4.5 years are sustained at 10 years, to evaluate if these interventions reduce health disparities, and whether social conditions and maternal stressors modify the effect on children of the interventions, and to analyse the public health impact and the cost-utility of the interventions in order to inform policy and possibilities for scaling-up.