Document Detail

Micronutrient supplementation and pregnancy outcomes: double-blind randomized controlled trial in China.
MedLine Citation:
PMID:  23303315     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Beyond perinatal folic acid supplementation, the need for additional prenatal prophylaxis of iron with or without other micronutrients remains unclear. We aim to investigate the maternal and infant health effects of iron plus folic acid and multiple micronutrient supplements vs folic acid alone when provided to pregnant women with no or mild anemia.
METHODS: In this randomized double-blind controlled trial, 18,775 nulliparous pregnant women with mild or no anemia were enrolled from 5 counties of northern China from May 2006 through April 2009. Women were randomly assigned to daily folic acid (400 μg) (control), folic acid-iron (30 mg), or folic acid, iron, and 13 additional vitamins and minerals provided before 20 weeks gestation to delivery. Primary outcome was perinatal mortality. Secondary outcomes included neonatal and infant mortality, preterm delivery, birth weight, birth length, gestational duration, and maternal hemoglobin concentration and anemia.
RESULTS: A total of 92.7% of women consumed 80% to 100% of supplements as instructed. On average, women consumed 177 supplements. Compared with daily prenatal folic acid, supplementation with iron-folic acid with or without other micronutrients did not affect the rate of perinatal mortality (8.8, 8.7, and 8.3, respectively) per 1000 births, and relative risks (RRs) were 1.00 (95% CI, 0.68-1.46; P = .99) and 0.94 (95% CI, 0.64-1.39; P = .76), respectively. Risk of other adverse maternal and infant outcomes also did not differ, except that RRs for third-trimester maternal anemia were 0.72 (95% CI, 0.63-0.83; P < .001) and 0.71 (95% CI, 0.62-0.82; P < .001), respectively.
CONCLUSION: Prenatal iron-folic acid and other micronutrient supplements provided to Chinese women with no or mild anemia prevented later pregnancy anemia beyond any benefit conferred by folic acid alone but did not affect perinatal mortality or other infant outcomes.
TRIAL REGISTRATION: Identifier: NCT00133744.
Jian-meng Liu; Zuguo Mei; Rongwei Ye; Mary K Serdula; Aiguo Ren; Mary E Cogswell
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA internal medicine     Volume:  173     ISSN:  2168-6114     ISO Abbreviation:  JAMA Intern Med     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-26     Completed Date:  2013-04-16     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101589534     Medline TA:  JAMA Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  276-82     Citation Subset:  AIM; IM    
Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
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MeSH Terms
Anemia / drug therapy
Birth Weight / drug effects
Double-Blind Method
Folic Acid / therapeutic use*
Infant Mortality
Infant, Newborn
Iron / therapeutic use*
Micronutrients / therapeutic use*
Perinatal Mortality
Pregnancy Complications / drug therapy
Pregnancy Outcome*
Premature Birth
Prenatal Nutritional Physiological Phenomena
Trace Elements / therapeutic use*
Reg. No./Substance:
0/Micronutrients; 0/Trace Elements; 59-30-3/Folic Acid; 7439-89-6/Iron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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