{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:29:11Z","timestamp":1791203351895,"version":"4.2.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,7,21]],"date-time":"2015-07-21T00:00:00Z","timestamp":1437436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"University of California, Davis from the Bill and Melinda Gates Foundation","award":["AID-OAA-A-12-00005"],"award-info":[{"award-number":["AID-OAA-A-12-00005"]}]},{"name":"Office of Health, Infectious Diseases, and Nutrition, Bureau for Global Health, US Agency for International Development (USAID)"}],"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>Nutritional supplementation during pregnancy is increasingly recommended especially in low\u2010resource settings, but its oral health impacts have not been studied. Our aim was to examine whether supplementation with multiple micronutrients (<jats:styled-content style=\"fixed-case\">MMN<\/jats:styled-content>) or small\u2010quantity lipid\u2010based nutrient supplements affects dental caries development or periodontal health in a rural Malawian population. The study was embedded in a controlled <jats:styled-content style=\"fixed-case\">iLiNS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DYAD<\/jats:styled-content> trial that enrolled 1391 pregnant women &lt;20 gestation weeks. Women were provided with one daily iron\u2013folic acid capsule (<jats:styled-content style=\"fixed-case\">IFA<\/jats:styled-content>), one capsule with 18 micronutrients (<jats:styled-content style=\"fixed-case\">MMN<\/jats:styled-content>) or one sachet of lipid\u2010based nutrient supplements (<jats:styled-content style=\"fixed-case\">LNS<\/jats:styled-content>) containing protein, carbohydrates, essential fatty acids and 21 micronutrients. Oral examination of 1024 participants was conducted and panoramic <jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray taken within 6 weeks after delivery. The supplement groups were similar at baseline in average socio\u2010economic, nutritional and health status. At the end of the intervention, the prevalence of caries was 56.7%, 69.1% and 63.3% (<jats:italic>P<\/jats:italic>\u2009=\u20090.004), and periodontitis 34.9%, 29.8% and 31.2% (<jats:italic>P<\/jats:italic>\u2009=\u20090.338) in the <jats:styled-content style=\"fixed-case\">IFA<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">MMN<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LNS<\/jats:styled-content> groups, respectively. Compared with the <jats:styled-content style=\"fixed-case\">IFA<\/jats:styled-content> group, women in the <jats:styled-content style=\"fixed-case\">MMN<\/jats:styled-content> group had 0.60 (0.18\u20131.02) and in the <jats:styled-content style=\"fixed-case\">LNS<\/jats:styled-content> group 0.59 (0.17\u20131.01) higher mean number of caries lesions. In the absence of baseline oral health data, firm conclusions on causality cannot be drawn. However, although not confirmatory, the findings are consistent with a possibility that provision of <jats:styled-content style=\"fixed-case\">MMN<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">LNS<\/jats:styled-content> may have increased the caries incidence in this target population. Because of the potential public health impacts, further research on the association between gestational nutrient interventions and oral health in low\u2010income settings is needed.<\/jats:p>","DOI":"10.1111\/mcn.12204","type":"journal-article","created":{"date-parts":[[2015,7,21]],"date-time":"2015-07-21T05:49:43Z","timestamp":1437457783000},"page":"99-110","source":"Crossref","is-referenced-by-count":4,"title":["Nutrient supplementation may adversely affect maternal oral health \u2013 a randomised controlled trial in rural <scp>M<\/scp>alawi"],"prefix":"10.1111","volume":"12","author":[{"given":"Ulla","family":"Harjunmaa","sequence":"first","affiliation":[{"name":"Department of International Health University of Tampere School of Medicine  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorma","family":"J\u00e4rnstedt","sequence":"additional","affiliation":[{"name":"Department of Radiology Medical Imaging Center Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn G.","family":"Dewey","sequence":"additional","affiliation":[{"name":"Department of Nutrition University of California Davis  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla","family":"Ashorn","sequence":"additional","affiliation":[{"name":"Department of International Health University of Tampere School of Medicine  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Maleta","sequence":"additional","affiliation":[{"name":"Department of Community Health University of Malawi College of Medicine  Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Vosti","sequence":"additional","affiliation":[{"name":"Department of Agricultural and Resource Economics University of California Davis  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Ashorn","sequence":"additional","affiliation":[{"name":"Department of International Health University of Tampere School of Medicine  Tampere Finland"},{"name":"Department of Paediatrics Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2011.04.011"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12049"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.088617"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.OGX.0000083542.14439.CF"},{"key":"e_1_2_9_6_1","volume-title":"The Oral Health Atlas. 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