Nutritional supplementation during pregnancy and offspring cardiovascular disease risk in The Gambia

• Published in: The American journal of clinical nutrition 2011-12, Vol.94 (6 Suppl), p.1853S-1860S
• Main Authors: Hawkesworth, Sophie, Walker, Celia G, Sawo, Yankuba, Fulford, Anthony J C, Jarjou, Landing M A, Goldberg, Gail R, Prentice, Ann, Prentice, Andrew M, Moore, Sophie E
• Format: Article
• Language: English
• Subjects: Adolescent; Blood Pressure; Calcium, Dietary - administration & dosage; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Child; Cholesterol - blood; Dietary Proteins - administration & dosage; Dietary Supplements; Double-Blind Method; Female; Follow-Up Studies; Gambia - epidemiology; Humans; Male; Malnutrition - complications; Nutrition; Pregnancy; Prenatal Exposure Delayed Effects - etiology; Prenatal Exposure Delayed Effects - pathology; Prenatal Nutritional Physiological Phenomena; Prevalence; Proteins; Risk assessment; Risk Factors
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.110.000877

Maternal nutritional intake during pregnancy may have important consequences for long-term health in offspring. The objective was to follow up the offspring in 2 randomized trials of nutrient supplementation during pregnancy to investigate the effect on cardiovascular disease (CVD) risk in offspring. We recruited offspring born during 2 trials in The Gambia, West Africa. One trial provided protein-energy-dense food supplements (1015 kcal and 22 g protein/d) to pregnant (intervention, from 20 wk gestation until delivery) or lactating (control, for 20 wk from birth) women and was randomized at the village level. The second was a double-blind, individually randomized, placebo-controlled trial of calcium supplementation (1.5 g/d), which was also provided from 20 wk gestation until delivery. Sixty-two percent (n = 1267) of children (aged 11-17 y) born during the protein-energy trial were recruited and included in the analysis, and 64% (n = 350) of children (aged 5-10 y) born during the calcium trial were recruited and included in the analysis. Fasted plasma glucose was marginally lower in children born to mothers receiving protein-energy supplements during pregnancy than in those children of the lactating group (adjusted mean difference: -0.05 mmol/L; 95% CI: -0.10, -0.001 mmol/L). There were no other differences in CVD risk factors, including blood pressure, body composition, and cholesterol, between children born to intervention and control women from the protein-energy trial. Maternal calcium supplementation during pregnancy was unrelated to offspring blood pressure. These data suggest that providing supplements to pregnant women in the second half of pregnancy may have little effect on the CVD risk of their offspring, at least in this setting and at the ages studied here. This trial was registered at www.controlled-trials.com as ISRCTN96502494.