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Multi-nutrient vs. iron-folic acid supplementation during pregnancy

Posted:  Tuesday, January 06, 2015

When it comes to nutrition in pregnancies, mothers from resource poor countries might most commonly experience multiple micronutrient deficiency, low birth weight infant, preterm birth, small size for gestational age, stillbirth, infant mortality, and maternal mortality. In one such study conducted in Bangladesh, maternal multiple micronutrient supplementation before and after childbirth resulted in significant reductions in preterm birth and low birth weight as compared to only iron-folic acid supplementation.

The results of the study were published in the December issue of The Journal of the American Medical Association. The study involved 44,567 pregnant women from Bangladesh and were randomly assigned to receive supplements containing 15 micronutrients or iron-folic acid alone, taken daily from early pregnancy to 12 weeks postpartum.

Among the pregnancies in the multiple micronutrient group and in the iron-folic acid group, there were 14,374 and 14,142 live-born infants respectively which were included in the analysis. At 6 months, multiple micronutrient supplementation did not significantly reduce infant mortality in comparison to the iron-folic acid group. However, it resulted in a significant reduction in preterm births and LBW babies whereas a non-statistically significant reduction in stillbirths was observed.

"Our study's null finding is in agreement with a small number of trials that have provided an antenatal multiple micronutrient vs. iron supplement, with or without folic acid, and found no effect on neonatal mortality,” said the authors. They further added, “Reasons for a null effect on postnatal survival after improvement in some birth outcomes with antenatal multiple micronutrient supplement use remain unknown but may reflect a complex interplay between maternal and newborn sizes and differential responses to supplementation by causes of death."

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