Nepal Project Aims to Reduce Pregnancy Risk with Daily Nutritional Supplement


November 6, 2017

The Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University today announced a $4.9 million grant from the Bill & Melinda Gates Foundation for a four-year project that aims to reduce the risk of small-for-gestational-age (SGA) babies born in southern Nepal and improve their growth during the first 6 months of life. A research team led by James M. Tielsch, PhD, Professor and Chair of the Department of Global Health at the Milken Institute SPH will evaluate whether a fortified balanced protein-energy supplement taken during pregnancy and during the first 6 months after delivery can prevent such adverse outcomes in southern Nepal.

Many pregnant women in Nepal and other areas in south Asia are undernourished to begin with and evidence suggests that food intake may be inadequate during pregnancy for a variety of reasons, including a lack of appetite. When thin or malnourished women become pregnant they are at risk of delivering a small baby with health consequences that can be lifelong.

The research team with investigators from the Milken Institute SPH, the Johns Hopkins Bloomberg School of Public Health and the Harvard T.H. Chan School of Public Health will first identify a dietary supplement that will supply the nutrients thought to keep the developing baby healthy and also be accepted by this population of women.  

The team will then test the selected nutritional supplement in about 1800 pregnancies in the Sarlahi District of Nepal, which is along the border with India. Women will be randomly assigned to one of 4 groups: those receiving the daily supplement during pregnancy and the first 6 months following delivery, those receiving the supplement only during pregnancy, those receiving the supplement only after the baby is born, and a control group that consumes their regular diet 

All mothers and babies will be followed through pregnancy and until 6 months post-partum.  A sample will be followed until 12 months to assess whether there are benefits that extend past the supplementation period.  “The estimated incidence of small-for-gestational-age births is from 30 to 40 percent in Nepal,” says Tielsch. “In this project, we hope to identify a nutritional supplement that could reduce that percentage and help Nepalese women get the nutrients they need to deliver a healthy baby and improve their growth in those important first 6 months of life”