How do we lower the amount of preterm or low weight births?
Dongqing Wang, Assistant Professor in the Department of Global and Community Health at George Mason University’s College of Public Health, examines one solution.
Dongqing Wang is an Assistant Professor in the Department of Global and Community Health. Wang’s research focuses on the nutritional determinants of maternal, child, and adolescent health in low- and middle-income countries. A primary domain of Wang’s research is the distributions, determinants, and consequences of inadequate and excessive gestational weight gain in low- and middle-income countries. Wang’s research addresses knowledge gaps related to gestational weight gain by pooling individual participant data from national surveys, observational cohort studies, and randomized controlled trials. Another key area of Wang’s work is the impacts of maternal nutrient and food supplementation on the short- and long-term health of mothers and children. Wang is also interested in adolescent nutrition and school-based interventions to address the double burden of adolescent malnutrition. Wang is the Co-Investigator of several randomized controlled trials of nutritional interventions among mothers, children, and adolescents in sub-Saharan Africa. Before coming to Mason, Wang was a Research Associate in the Department of Global Health and Population at Harvard T.H. Chan School of Public Health.
Preterm Birth and Nutritional Supplements
Preterm birth, low birthweight, and small-for-gestational-age births are the birth outcomes most likely to result in infant death. In the past, these outcomes were studied and treated as separate conditions. We know that prenatal nutritional supplements can reduce the risk of these outcomes, but small vulnerable newborn types may have distinct challenges and health impact and require additional intervention strategies. For example, low birthweight can occur either because of a short pregnancy duration or because of fetal growth restrictions that lead to babies born too small for their gestational age.
Our team looked at these birth outcomes, not as isolated occurrences but in combinations. We wanted to know how prenatal nutritional supplements affect the risks of different types of small vulnerable newborns. Iron and folic acid supplements have been the standard of care since the 1970s, but we hypothesized that supplements using multiple micronutrients could more effectively prevent the occurrence of small vulnerable babies and thereby reduce infant mortality.
We combined data from 16 randomized controlled trials where women received multiple micronutrient supplements, or MMS during pregnancy. We focused on low- and middle-income countries in this work, because the majority of small vulnerable babies occur in these settings. We found that using MMS during pregnancy can lower the risk of giving birth to small and vulnerable newborns by as much as 27% compared to iron and folic acid supplements alone. Our work suggests that MMS should replace iron and folic acid as the standard prenatal care in low- and middle-income countries.
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