Multiple micronutrient supplementation during pregnancy in low-income countries: a meta-analysis of effects on stillbirths and on early and late neonatal mortality.


Ronsmans, C; Fisher, DJ; Osmond, C; Margetts, BM; Fall, CH; Maternal Micronutrient Supplementation Study Group, ; , COLLABORATORS; Adou, P; Aguayo, VM; Allen, LH; Bhutta, ZA; Christian, P; Dang, S; Desplats, G; Dibley, M; El Arifeen, S; Fall, C; Fisher, D; Friis, H; Gomo, E; Haider, BA; Hidayat, A; Jahari, A; Kaestel, P; Kolsteren, P; Kusharisupeni, ; Mamadoultaibou, A; Mandandhar, DS; Margetts, B; Osmond, C; Osrin, D; Persson, LA; Ramakrishnan, U; Roberfroid, D; Ronsmans, C; Shankar, AH; Subarkah, ; Sunawang, ; Utomo, B; Vaidya, A; Yan, H; Zagre, N; Zeng, L; (2009) Multiple micronutrient supplementation during pregnancy in low-income countries: a meta-analysis of effects on stillbirths and on early and late neonatal mortality. Food and nutrition bulletin, 30 (4 Suppl). S547-55. ISSN 0379-5721

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Abstract

BACKGROUND: Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes.<br/> OBJECTIVE: To conduct a meta-analysis of the effects on stillbirths and on early and late neonatal mortality of supplementation during pregnancy with multiple micronutrients compared with iron-folic acid in recent randomized, controlled trials.<br/> METHODS: Twelve randomized, controlled trials were included in the analysis (Bangladesh; Burkina Faso; China; Guinea-Bissau; Indramayu and Lombok, Indonesia; Mexico; Sarlahi and Janakur, Nepal; Niger; Pakistan; and Zimbabwe), all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients or iron-folic acid to presumed HIV-negative women.<br/> RESULTS: Supplementation providing approximately I RDA of multiple micronutrients did not decrease the risk of stillbirth (OR = 1.01; 95% CI, 0.88 to 1.16), early neonatal mortality (OR = 1.23; 95% CI, 0.95 to 1.59), late neonatal mortality (OR = 0.94; 95% CI, 0.73 to 1.23), or perinatal mortality (OR = 1.11; 95% CI, 0.93 to 1.33).<br/> CONCLUSIONS: Our meta-analysis provides consistent evidence that supplementation providing approximately 1 RDA of multiple micronutrients during pregnancy does not result in any reduction in stillbirths or in early or late neonatal deaths compared with iron-folic acid alone.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Maternal Health Group
PubMed ID: 20120796
URI: http://researchonline.lshtm.ac.uk/id/eprint/4121

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