Poor nutrition, including micronutrient deficiencies, during pregnancy can have serious consequences for the health of both mothers and children as such deficiencies during critical periods in utero and early childhood can have lasting health and developmental effects throughout the lifespan. Women’s need for nutrients increases during pregnancy, and there is compelling evidence that multiple micronutrient supplementation (MMS) during pregnancy improves maternal health, birth outcomes, and child health. However, there is substantial uncertainty regarding the optimal composition of the MMS. In the MoMS project three different MMS formulations will be given from early pregnancy to 6 months postpartum while comparing maternal and child health, risk of metabolic illness, and development. Factors modifying the effect of the intervention will also be explored in an observational design; to investigate to what extent these factors are associated with the outcomes.
The main study will be a double-blind, individual randomized, controlled trial in 3000 pregnant women in Western Kenya. Women will be recruited from antenatal clinics and randomized to 3 different MMS groups in a ratio of 1:1:1. The pregnant women will be provided with a supplement every day throughout pregnancy and 6 months postpartum and followed up at least until the babies’ 1st birthday. A key component of the project is to establish a cohort and a biobank that can address critical research questions related to maternal and child health, nutrition, environmental exposures, growth, obesity and cardiometabolic disease.
The overall aims of the study is 1) to improve micronutrient composition of MMS for pregnant women in low- and middle-income countries, 2) to identify early life risk factors for poor pregnancy outcomes, poor growth in early childhood and risk factors for metabolic illnesses in later life, and 3) to establish a birth cohort that captures a broad range of early life exposures related to psychological stress, nutrition, illness, and environmental exposures and relate these exposures to subsequent health and developmental outcomes such as obesity and non-communicable diseases.
The primary outcomes are birth weight and infant lean body mass while key secondary outcomes are other birth and neonatal outcomes, neurodevelopment, metabolic health, growth trajectories of infants using several anthropometric indices and micronutrient status.
The MoMS project will provide causal evidence for the optimal micronutrient composition for pregnant and lactating women that can be generalized beyond the study sites. The study will also provide critical knowledge on the relationship between early life exposures, health, child development, and metabolic illnesses, including obesity and cardiometabolic disease. Hence the study will benefit society by potentially reducing the risk of being born too early or too small, in addition to improving health for pregnant women, fetuses, and children as they grow to become adults.
The project is led by PI Dr. Zipporah Bukania (Kenya Medical Research Institute, Kenya) with Co-PI Professor Tor Strand (Innlandet Hospital Trust, Norway) and Co-PI Associate Professor Benedikte Grenov (University of Copenhagen, Denmark).
