{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:22:40Z","timestamp":1790043760495,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,7,31]],"date-time":"2022-07-31T00:00:00Z","timestamp":1659225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP49817"],"award-info":[{"award-number":["OPP49817"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In populations with a high prevalence of childhood and adolescent undernutrition, supplementation during pregnancy aiming at improving maternal nutritional status and preventing fetal growth restriction might theoretically lead to cephalopelvic disproportion and delivery complications. We investigated whether the prenatal provision of small\u2010quantity lipid\u2010based nutrient supplements (SQ\u2010LNS) was associated with an increased risk of caesarean section (CS) or other delivery complications. Pregnant Malawian women were randomised to receive daily i) iron\u2013folic acid (IFA) capsule (control), ii) multiple micronutrient (MMN) capsule of 18 micronutrients (second control), or iii) SQ\u2010LNS with similar micronutrients as MMN, plus four minerals and macronutrients contributing 118\u2009kcal. We analysed the associations of SQ\u2010LNS, CS, and other delivery complications using log\u2010binomial regressions. Among 1391 women enrolled, 1255 had delivery information available. The incidence of CS and delivery complications was 6.3% and 8.2%, respectively. The incidence of CS was 4.0%, 6.0%, and 8.9% (<jats:italic>p<\/jats:italic>\u2009=\u20090.017) in the IFA, MMN, and LNS groups, respectively. Compared to the IFA group, the relative risk (95% confidence interval) of CS was 2.2 (1.3\u20133.8) (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) in the LNS group and 1.5 (0.8\u20132.7) (<jats:italic>p<\/jats:italic>\u2009=\u20090.200) in the MMN group. We found no significant differences for other delivery complications. Provision of SQ\u2010LNS to pregnant women may have increased the incidence of CS. The baseline rate was, however, lower than recommended. It is unclear if the higher CS incidence in the SQ\u2010LNS group resulted from increased obstetric needs or more active health seeking and a better supply of services. Trial registered at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>, NCT01239693.<\/jats:p>","DOI":"10.1111\/mcn.13414","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T06:44:35Z","timestamp":1659336275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between prenatal provision of lipid\u2010based nutrient supplements and caesarean delivery: Findings from a randomised controlled trial in Malawi"],"prefix":"10.1111","volume":"18","author":[{"given":"Meeri","family":"Salenius","sequence":"first","affiliation":[{"name":"Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Pyykk\u00f6","sequence":"additional","affiliation":[{"name":"Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1720-868X","authenticated-orcid":false,"given":"Ulla","family":"Ashorn","sequence":"additional","affiliation":[{"name":"Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn G.","family":"Dewey","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition and Department of Nutrition University of California Davis Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austrida","family":"Gondwe","sequence":"additional","affiliation":[{"name":"School of Public Health and Family Medicine,\u00a0College of Medicine University of Malawi Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla","family":"Harjunmaa","sequence":"additional","affiliation":[{"name":"Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Maleta","sequence":"additional","affiliation":[{"name":"School of Public Health and Family Medicine,\u00a0College of Medicine University of Malawi Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minyanga","family":"Nkhoma","sequence":"additional","affiliation":[{"name":"Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Vosti","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition and Department of Nutrition University of California Davis Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Ashorn","sequence":"additional","affiliation":[{"name":"Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University Tampere Finland"},{"name":"Department of Paediatrics Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0973-9533","authenticated-orcid":false,"given":"Laura","family":"Adubra","sequence":"additional","affiliation":[{"name":"Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/86.2.412"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.088617"},{"key":"e_1_2_9_4_1","unstructured":"Ashorn P. Poelman B. Dewey K. G. Maleta K. Klein N. Rogerson S. &Meshnick S. R.(2017). The impact of dietary supplementation with lipid\u2010based nutrient supplements on maternal health and pregnancy outcomes in rural Malawi. 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Retrieved May 22 2022 fromhttps:\/\/data.unicef.org\/resources\/data_explorer\/unicef_f\/?ag=UNICEF%26df=GLOBAL_DATAFLOW%26ver=1.0%26dq=MWI.MNCH_CSEC.%26startPeriod=1970%26endPeriod=2022"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqab276"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.13414","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.13414","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.13414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T17:15:42Z","timestamp":1692724542000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.13414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,31]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/mcn.13414"],"URL":"https:\/\/doi.org\/10.1111\/mcn.13414","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,31]]},"assertion":[{"value":"2022-02-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13414"}}