{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T03:04:07Z","timestamp":1782529447626,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T00:00:00Z","timestamp":1406160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Bill and Melinda Gates Foundation, Seattle, WA, USA"},{"name":"Sight and Life Global Nutrition Research Institute, Baltimore, MD, USA"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Antenatal iron and multiple micronutrient supplementation has been shown in randomized trials to improve birthweight, although mechanisms are unknown. We examined late pregnancy serum erythropoietin (<jats:styled-content style=\"fixed-case\">EPO<\/jats:styled-content>) and cortisol concentrations in relation to maternal micronutrient supplementation and iron status indicators (haemoglobin, serum ferritin, soluble transferrin receptor) in 737 rural <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>epalese women to explore evidence of stress or anaemia\u2010associated hypoxia. A double\u2010masked randomized control trial was conducted from <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 1998 to <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>pril 2001 in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>arlahi, <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>epal, in which women received vitamin <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> alone (as control), or with folic acid (<jats:styled-content style=\"fixed-case\">FA<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">FA<\/jats:styled-content>\u2009+\u2009iron, <jats:styled-content style=\"fixed-case\">FA<\/jats:styled-content>\u2009+\u2009iron\u2009+\u2009zinc and a multiple micronutrient supplement. In a substudy, we collected maternal blood in the first and third trimester for biochemical assessments. Generalized estimating equations linear regression analysis was used to examine treatment group differences. <jats:styled-content style=\"fixed-case\">EPO<\/jats:styled-content> was \u223c14\u201317\u2009<jats:styled-content style=\"fixed-case\">mIU<\/jats:styled-content>\u2009<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content><jats:sup>\u22121<\/jats:sup> lower (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) in late pregnancy in groups receiving iron vs. the control group, with no difference in the <jats:styled-content style=\"fixed-case\">FA<\/jats:styled-content>\u2010only group. Cortisol was 1.3\u2009<jats:italic>\u03bc<\/jats:italic>g\u2009<jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content><jats:sup>\u22121<\/jats:sup> lower (<jats:italic>P<\/jats:italic>\u2009=\u20090.04) only in the micronutrient supplement group compared with the control group. <jats:styled-content style=\"fixed-case\">EPO<\/jats:styled-content> was most strongly associated with iron status indicators in groups that did not receive iron, and in the non\u2010iron groups cortisol was positively correlated with <jats:styled-content style=\"fixed-case\">EPO<\/jats:styled-content> (<jats:italic>r<\/jats:italic>\u2009=\u20090.15, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) and soluble transferrin receptor (<jats:styled-content style=\"fixed-case\">sTfR<\/jats:styled-content>, <jats:italic>r<\/jats:italic>\u2009=\u20090.19, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In adjusted analyses, third trimester <jats:styled-content style=\"fixed-case\">EPO<\/jats:styled-content> was associated with a reduction in low birthweight, whereas cortisol was negatively associated with length of gestation and higher risk of preterm birth. Iron and multiple micronutrient supplementation may enhance birth outcomes by reducing mediators of maternal stress and impaired erythropoiesis.<\/jats:p>","DOI":"10.1111\/mcn.12138","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T11:02:24Z","timestamp":1406199744000},"page":"64-73","source":"Crossref","is-referenced-by-count":11,"title":["Antenatal micronutrient supplementation and third trimester cortisol and erythropoietin concentrations"],"prefix":"10.1111","volume":"12","author":[{"given":"Parul","family":"Christian","sequence":"first","affiliation":[{"name":"Center for Human Nutrition Department of International Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashika","family":"Nanayakkara\u2010Bind","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition Department of International Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Schulze","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition Department of International Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Wu","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition Department of International Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"LeClerq","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition Department of International Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"The Nepal Nutrition Intervention Project\u2010Sarlahi  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subarna K.","family":"Khatry","sequence":"additional","affiliation":[{"name":"The Nepal Nutrition Intervention Project\u2010Sarlahi  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,7,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/131.2.581S"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60996-4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-010-0183-1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-59745-112-3_21"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.nutr.012809.104813"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/133.11.3492"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7389.571"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.6.1194"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/83.4.788"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980000000173"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2012.70"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2012.01312.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/135.5.1106"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/136.5.1389"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-2760(98)00146-5"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm0595-460"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2012.01276.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/131.2.590S"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.peptides.2005.10.002"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1095\/biolreprod60.3.541"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7183.570"},{"key":"e_1_2_8_23_1","volume-title":"Worldwide Prevalence of Anaemia 1993\u22122005: WHO Global Database on Anaemia","author":"World Health Organization","year":"2008"}],"container-title":["Maternal &amp; 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