Effects of prenatal early food and micronutrient supplementations on body size and cardiometabolic risk factors in the 15-year-old offspring – the MINIMat randomised trial

BACKGROUND: Evidence on the effects of maternal nutrition during pregnancy on offspring cardiometabolic risk is mixed. We hypothesized that 15-year-olds, whose mothers were randomised to maternal early pregnancy protein-energy supplementation, are taller and have lower low-density lipoprotein cholesterol than controls. We also assessed effects of prenatal multiple micronutrient supplementation (MMS) on adolescent body size and cardiometabolic risk factors. METHODS: In MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab; ISRCTN16581394) in rural Bangladesh, pregnant women were randomised in a 2:3 factorial design to early invitation to food supplementation (around gestational week 9), vs standard programme (usual invitation); MMS was compared with folic acid and iron. Of 3267 singletons with valid birth weight, 2300 (70.4%) were measured height and weight, plasma cardiometabolic biomarkers and blood pressure at 15 years, between September 2017 and June 2019. We analysed data by linear and logistic regression, adjusting for sex, age and prenatal confounders. FINDINGS: Adolescents whose mothers received early invitation had 0.08 units higher height z score (95% CI 0.01, 0.16) and less of them were stunted (<-2 SD; 17.4% vs 21.4%, risk difference 4.1%; 95% CI 0.8%, 7.3%; OR 0.77; 0.63, 0.95) than usual invitation group. Early invitation and MMS were unrelated to BMI, plasma cardiometabolic biomarkers or blood pressure. INTERPRETATION: The effect of early prenatal food supplementation on height persists at 15 years. We found no effect of this intervention or MMS on cardiometabolic factors. FUNDING: Swedish Research Council, Finnish Research Council, Finska Läkaresällskapet, Pediatric Research, Novo Nordisk, Gyllenberg and Jusélius Foundations.