Effect of Preconceptional Micronutrient Supplementation on Serum Concentration of Human Placental Lactogen at Last Pregnancy: A Randomized Double Blind Control Trial

• Published in: Annals of nutrition and metabolism 2019-01, Vol.75, p.68
• Main Authors: Sumarmi, Sri, Kuntoro, Dachlan, Erry Gumilar, Wirjatmadi, Bambang, Thaha, Abdul Razak, Soekirman
• Format: Article
• Language: English
• Subjects: Clinical trials; Dietary supplements; Folic acid; Iron; Micronutrients; Minerals; Nutrition; Placebos; Placenta; Pregnancy; Retinene; Supplements; Vitamin A
• ISSN: 0250-6807; 1421-9697
• DOI: 10.1159/000501751

Background/Aims: Human placental lactogen (hPL) is a specific and most important hormone secreted during pregnancy, and its production might stimulated by several micronutrients. The study was conducted to evaluate the efficacy of micronutrients supplementation during preconception period on concentration of human placental lactogen at last pregnancy, compare to iron folic acid supplementation. Methods: A randomized double-blind community-based trial was conducted at East Java. Study subjects were randomly assigned into two group: MMN group received micronutrient containing 14 vitamin-minerals during preconception, continue during pregnancy, IFA group received placebo during preconception period and continue iron and folate during pregnancy. Total of 420 eligible subjects were enrolled, and 115 subjects were included final analysis. The outcome variable was serum hPL at week 35th of pregnancy. The initial status of iron, zinc and vitamin A were assessed. General linear model was used to test baseline data, independent t test was used to analyze the mean different of hPL concentration between two groups. Register trial number TCTR20150614001 was from Thai Clinical Trials Registry. Results: Subjects who received micronutrients supplementation during preconception period have higher hPL concentration (8.50 ± 1.90 mg/L) compared to subject who received iron folic acid (7.36 ± 2.15 mg/L) (p = 0.014). Serum retinol was also different between two group, but not iron status. Conclusion: Supplementation of micronutrients begin at preconception period improved concentration of human placental lactogen better than iron folic acid supplementation only during pregnancy. The improvement of hPL by 1.14 g/L might be mediated by the improvement of vitamin A status.