| Multiple micronutrient supplementation during pregnancy in developing-country settings: policy and program implications of the results of a meta-analysis. | |
MedLine Citation:
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PMID: 20120797 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: An independent Systematic Review Team performed a meta-analysis of 12 randomized, controlled trials comparing multiple micronutrients with daily iron-folic acid supplementation during pregnancy. OBJECTIVE: To provide an independent interpretation of the policy and program implications of the results of the meta-analysis. METHODS: A group of policy and program experts performed an independent review of the meta-analysis results, analyzing internal and external validity and drawing conclusions on the program implications. RESULTS: Although iron content was often lower in the multiple micronutrient supplement than in the iron-folic acid supplement, both supplements were equally effective in tackling anemia. Community-based supplementation ensured high adherence, but some mothers still remained anemic, indicating the need to concomitantly treat infections. The small, significant increase in mean birthweight among infants of mothers receiving multiple micronutrients compared with infants of mothers receiving iron-folic acid is of similar magnitude to that produced by food supplementation during pregnancy. Larger micronutrient doses seem to produce greater impact. Meaningful improvements have also been observed in height and cognitive development of the children by 2 years of age. There were no significant differences in the rates of stillbirth, early neonatal death, or neonatal death between the supplemented groups. The nonsignificant trend toward increased early neonatal mortality observed in the groups receiving multiple micronutrients may be related to differences across trials in the rate of adolescent pregnancies, continuing iron deficiency, and/or adequacy of postpartum health care and merits further investigation. CONCLUSIONS: Replacing iron-folic acid supplements with multiple micronutrient supplements in the package of health and nutrition interventions delivered to mothers during pregnancy will improve the impact of supplementation on birthweight and on child growth and development. |
Authors:
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Roger Shrimpton; Sandra L Huffman; Elizabeth R Zehner; Ian Darnton-Hill; Nita Dalmiya |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Food and nutrition bulletin Volume: 30 ISSN: 0379-5721 ISO Abbreviation: Food Nutr Bull Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2010-02-03 Completed Date: 2010-03-11 Revised Date: 2010-05-18 |
Medline Journal Info:
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Nlm Unique ID: 7906418 Medline TA: Food Nutr Bull Country: Japan |
Other Details:
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Languages: eng Pagination: S556-73 Citation Subset: IM |
Affiliation:
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Institute of Child Health, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anemia, Iron-Deficiency
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drug therapy,
prevention & control Birth Weight Developing Countries / statistics & numerical data* Dietary Supplements * Female Fetal Mortality Folic Acid / administration & dosage Health Policy * Humans Infant Mortality Infant, Newborn Iron / administration & dosage Maternal Nutritional Physiological Phenomena * Meta-Analysis as Topic Micronutrients / administration & dosage*, deficiency Pregnancy Pregnancy Complications / drug therapy, prevention & control Pregnancy Outcome * Prenatal Care |
| Chemical | |
Reg. No./Substance:
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0/Micronutrients; 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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