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The efficacy and acceptability of prenatal Corn Soya Blend Plus dietary supplementation among women in rural Cambodia Janmohamed, Amynah


Corn Soya Blend (CSB) Plus is a micronutrient-fortified dietary supplement designed for women in Cambodia and elsewhere to help meet their nutritional needs in pregnancy, though little is known about its acceptance and ability to improve pregnancy outcomes. This research utilized a mixed methods approach to investigate the efficacy and acceptability of prenatal supplementation with CSB Plus among rural Cambodian women. A cluster-randomized trial was conducted in 75 villages in Kampong Chhnang Province, in which 547 women received the food supplement (treatment) on a monthly basis from the first trimester until delivery or continued their normal diet (control). Participants included women receiving antenatal care at a health facility in the first trimester. The primary outcome was birth weight and secondary outcomes were low birth weight (< 2500 grams), small for gestational age, birth length and head circumference, preterm birth (< 37 weeks), maternal weight gain, and anemia prevalence at 24-28, 30-32, and 36-38 weeks gestation. Cluster-adjusted linear mixed effect and logistic regression models were used to examine group differences. Acceptability of CSB Plus was investigated through structured interviews to understand consumption preferences and practices and six focus group discussions to explore perceptions, attitudes, and behaviors related to supplement utilization. CSB Plus resulted in a non-significant 46 g increase in birth weight (95% CI: -31, 123) and did not increase maternal weight gain or other measures of birth size. However, maternal anemia at 36-38 weeks (OR: 0.51; 95% CI: 0.34, 0.77) and preterm birth (OR: 0.33; 95% CI: 0.12, 0.89) were lower in the CSB Plus group. A significantly higher rate of fetal loss occurred in the treatment group. Acceptability was influenced by the product’s organoleptic qualities, family support, peer influences, trust in the provider of the supplement, and attitudes related to nutrition and weight in pregnancy. Acceptance was lower among first-time mothers, mainly due to fears of a large baby and resulting delivery complications. The findings of this research provide insight that can be used to guide future policy and programming decisions on the provision of Corn Soya Blend Plus and other prenatal dietary supplements in the Cambodian context.

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