(P07-018-23) Whether Antenatal Micronutrient Supplementation Having Benefit on Offspring Blood Pressure? A 14-Year Follow-Up of a Randomized Controlled Trial in China and Meta-Analysis

Objectives: Antenatal micronutrient supplementation improves birth outcomes, which has been shown to be associated with offspring blood pressure (BP). We aimed to examine the effects of antenatal micronutrient supplementation on adolescent BP.

Methods: We followed adolescents born to women who participated in a cluster randomized, double-blinded controlled trial of antenatal micronutrient supplementation conducted between 2002 and 2006. All pregnant women from each village in two rural counties in western China were randomized to take a daily capsule of folic acid (FA), folic acid plus iron (IFA), or multiple micronutrients (MMN). We assessed adolescent systolic and diastolic BP using validated electronic sphygmomanometer in 2016, which were then transferred into BP percentiles by adolescent age and height. We examined the effects of antenatal micronutrient supplementation on adolescent BP percentiles using generalized estimation equation. In addition, a meta-analysis was conducted after identifying similar trials that followed offspring and assessed their BP.

Results: Among 4488 singleton births eligible for long-term follow-up, 2118 (47.2%) adolescents aged 10-14 were followed, with 59.1% being male and a mean age of 11.71 (SD, 0.87) years. After adjusting for covariates, the MMN relative to FA group was associated with a 2.71 (95% CI -5.13, -0.28) point and a 2.56 (95% CI -4.99, -0.13) point lower systolic and diastolic BP percentile, respectively. The similar association was observed when comparing MMN to IFA. The corresponding adjusted mean differences were -1.32 (95% CI -4.13, 1.49) and-1.64 (95% CI -4.14, 0.86) points for systolic and diastolic BP percentile, respectively. In the meta-analysis including four trials with 5903 offspring, although the similar benefits of MMN relative to FA or IFA were observed, all the confidence intervals crossed the null point.

Conclusions: Antenatal micronutrient supplementation may exert some benefits on offspring blood pressure. Individual patient data meta-analysis should be pursued for addressing possible confounding and heterogeneity and identifying modifiers.

Funding Sources: This work was supported by the National Natural Science Foundation of China and China Postdoctoral Science Foundation.