Abstract
OBJECTIVE: The aim of the present study was to assess the association between prenatal multiple micronutrient supplementation (MMS) intake levels and gestational weight gain (GWG) recommendations in pregnant women in Indonesia. METHODS: We performed a population-based prospective cohort data collection during the rollout of MMS supplementation in Parepare, Indonesia. A total of 1216 pregnant women were enrolled and followed up until after delivery. Data on pre-pregnancy weight, height, and maternal parity were collected, as well as the starting trimester of MMS consumption and total number of tablets consumed. Weight measurements were performed at enrollment and in the late third trimester. The threshold applied for MMS adherence was ≥90 tablets. The Institute of Medicine 2009 guideline was used to determine GWG adequacy. Associations between total MMS consumption and GWG were assessed by binary logistic regression. RESULTS: Women with underweight, normal weight and overweight/obesity accounted for 11.4%, 58.1%, and 30.5% of the cohort, respectively; overall, 63.2% had inadequate, 26.3% had adequate, and 10.5% had excessive GWG; 53.9% consumed ≥90 MMS tablets. Crude analysis showed that women who consumed ≥90 MMS tablets had higher odds of achieving adequate GWG (OR = 1.34, 95% CI: 1.05-1.69). Several potential confounders were examined but did not materially affect the association. CONCLUSION: Our findings indicate that many women in Indonesia do not achieve adequate GWG. Ensuring the recommended MMS dose during pregnancy may improve nutrition status and increase the likelihood of adequate GWG. Thus, advice on the provision of MMS consumption and appropriate GWG should be part of antenatal care services for all pregnant women.