Low‐cost local food supplements could improve maternal and birth outcomes in Indonesia: A pilot randomised controlled trial

• Published in: Nutrition bulletin Vol. 46; no. 3; pp. 321 - 331
• Main Authors: Susiloretni, Kun A., Subandriani, Dyah Nur, Ulfiana, Elisa, Sunarto, Sunarto, Astuti, Trina, Smith, Emily Rose
• Format: Journal Article
• Language: English
• Published: Oxford Wiley Subscription Services, Inc 01.09.2021
• Subjects: Arm circumference; birth length; Birth weight; birthweight; caesarean delivery; Dietary supplements; Folic acid; Food; food supplements; Nuts; Pregnancy; undernourished pregnant mothers; Indonesia
• ISSN: 1471-9827; 1467-3010
• DOI: 10.1111/nbu.12519

Maternal nutrition plays a crucial role in influencing foetal growth and birth outcomes. The government of Indonesia provides centrally distributed food supplements (GFS) for undernourished pregnant mothers. The aim of the study was to test whether low‐cost, local food supplements (LFS) for undernourished pregnant mothers can improve maternal and birth outcomes compared with the centrally distributed GFS. This study was a two‐arm, randomised controlled trial design. The baseline data were collected at enrolment. We enrolled 60 pregnant mothers from Demak District, Central Java Province, Indonesia with mid‐upper arm circumference (MUAC) <23.5 cm who were assigned into two groups. The intervention group received LFS and multiple micronutrient supplements (MMS). The control group received the GFS and iron and folic acid supplements (IFA). LFS was a balanced energy protein food supplement made from peanuts, beans and fish. The effectiveness of these two interventions was assessed using logistic and linear regression. At baseline, the two groups had similar characteristics. After 60 days of treatment, compliance with the food and micronutrient supplements in the LFS group was 78.1% and 62.6% compared to 29.1% and 12.8% in the GFS group. After adjusting for baseline and the main covariates, mothers in the LFS group were more likely to increase MUAC (mean difference 0.60cm; 95% CI 0.27, 0.92) and to increase gestational weight (mean difference 1.02 kg; 95% CI 0.08, 1.97) than were mothers in the GFS group. For birth outcomes, the LFS group had a reduction in the risk of birthweight <3000 g (adjusted odds ratio [AOR] 0.15; 95% CI 0.02, 0.98), caesarean delivery (AOR 0.11; 95% CI 0.02, 0.60) and short birth length (AOR 0.07; 95% CI 0.01, 0.93) compared with the GFS group. Local foods and MMS supplementation can improve maternal and birth outcomes. Therefore, the provision of LFS can result in better compliance and better outcomes compared with centrally distributed GFS supplements.