Informations et ressources scientifiques
sur le développement des zones arides et semi-arides

Titre : The efficacy of fortified balanced energy-protein supplementation on diet of pregnant women and birth outcomes in rural Burkina Faso

Het effect van verrijkte energie-proteïne supplementen op het dieet van zwangere vrouwen en geboorte uitkomsten in ruraal Burkina Faso

Auteur : de Kok, Brenda

Université de soutenance : Gent University

Grade : PhD Thesis 2022

Sommaire partiel
Globally, malnutrition in all its forms remains a major challenge with serious consequences for health and wellbeing. It affects millions of people around the world and has a devastating developmental, economic and social impact on communities. Especially in low- and middle-income countries, unacceptable levels of undernutrition persist. Climate change, ongoing conflicts and the COVID-19 pandemic have triggered a global food crisis, putting even more women, infants and young children at risk of malnutrition. Poor maternal nutritional status not only affects a woman’s health, but also influences the health of her child (elaborated on in Chapter 1). Deficiencies in macro- and micronutrients during pregnancy are linked to poor fetal growth and development, which can lead to stillbirth, preterm delivery, small size at birth, and increased mortality and morbidity – during early childhood lasting into adulthood. Pregnancy is therefore viewed as a window to future health. To meet maternal needs and support fetal development, nutrition interventions that deliver additional energy and nutrients have the potential to improve pregnancy and birth outcomes. There is limited evidence that balanced energy-protein (BEP) supplementation (with less than 25% of energy from protein) during pregnancy improves birth weight, and reduces the risk of stillbirth and born small-for-gestational age (SGA). These conclusions on the impact of BEP supplementation should however be interpreted with caution due to the large heterogeneity in supplements, study populations and quality of the study designs. To address the critical need for high-quality studies, the ‘Micronutrients for Maternal and Child Health-III’ (in French : ‘Micronutriments pour la Santé de la Mère et de l’Enfant’, MISAME-III) research project in Burkina Faso was designed. In MISAME-III, an individually randomized controlled efficacy trial design was used to test the hypothesis that BEP supplementation during pregnancy results in a lower prevalence of SGA. In addition, the effect on large-for-gestational age, low birth weight (LBW ; less than 2500 g), preterm birth (before 37 weeks of pregnancy), gestational duration, birth weight, birth length, Rohrer’s ponderal index, head circumference, thoracic circumference, arm circumference, fetal loss and stillbirth was evaluated. The study protocol of MISAME-III is described in detail in Chapter 2 of this PhD thesis.

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