Objectives. Maternal nutrition plays a crucial role in influencing fetal growth and birth outcomes. The government of Indonesia has provided a manufactured fortified food supplementation program for undernourished pregnant mothers. We hypothesized a low-cost local food supplementation (LFS) would improve maternal and birth outcomes compared with government food supplementation (GFS).
Methods. We conducted a randomized control trial. We enrolled 54 pregnant mothers with MUAC<23.5cm 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 nuts and fish. LFS and GFS contained approximately 500kcal energy and 10grams protein. We compared the effectiveness of these two interventions using logistic and linear regression.
Results. At the baseline, the two groups had similar characteristics. After 60 days of treatment, mothers in the LFS group were 2.28 folds more likely to increase MUAC (RR 2.28; 95%CI 1.58,3.27, p<0.001) and 4.73 folds to increase gestational weight (RR 4.73; 95%CI 1.37,16.3, p=0.015) than were mothers in the GFS group. For birth outcomes, in the LFS group had reduction of birthweight <3000grams (RR 0.15; 95%CI 0.023,0.98; p=0.048), short birth length (RR 0.068; 95%CI 0.005,0.93; p=0.044), and cesarean delivery (RR 0.11; 95%CI 0.022,0.61, p=011) as compared to the GFS group.
Conclusions for Practice. Local foods and MMS supplementation can improve maternal and birth outcomes. Therefore, local food supplements can be considered for food supplementation programs to undernourished pregnant mothers.