Document Detail


Prenatal multiple micronutrient supplementation has greater impact on birthweight than supplementation with iron and folic acid: a cluster-randomized, double-blind, controlled programmatic study in rural Niger.
MedLine Citation:
PMID:  17974365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Micronutrient deficiencies during pregnancy are associated with adverse pregnancy outcomes, including reduced birthweight. Low birthweight is associated with increased risk of infant mortality and growth failure. OBJECTIVES: To assess the effects of prenatal supplementation with UNIMMAP (United Nations International Multiple Micronutrient Preparation) compared with iron/folic acid on average birthweight and incidence of low birthweight. METHODS: Pregnant women from 78 villages in Niger were included in a cluster-randomized, double-blinded, controlled supplementation trial. Baseline, monthly follow-up, and birth data were collected. Cluster analysis was conducted to assess differences in mean birthweight and incidence of low birthweight between groups using multiple linear regression models. Analyses were stratified by nutrition status and duration of supplementation. RESULTS: Of the 3,670 women recruited, 2,550 completed the study and provided complete birthweight data (1,328 received multiple micronutrients and 1,222 received iron/folic acid). Mean birthweight was significantly higher (67 g, p < .001) with multiple micronutrients (3,092 +/- 190 g) than with iron/folic acid (3,025 +/- 205 g); this corresponded to a 14% fall in the incidence of low birthweight (from 8.4% with multiple micronutrients to 7.2% with folic acid fortification). The impact of multiple micronutrients was greater when the supplements were taken for more than 150 days. The incidence of low birthweight was further reduced in women who entered pregnancy with a poorer nutrition status. CONCLUSIONS: Prenatal supplementation with multiple micronutrients had a greater positive impact on birthweight than supplementation with iron/folic acid. Our data suggest that prenatal supplementation with multiple micronutrients as part of a prenatal care package in addition to interventions to promote improved maternal prepregnancy nutrition status is an important strategy to increase birthweight and reduce the incidence of low birthweight.
Authors:
Noël M Zagré; Gwénola Desplats; Pierre Adou; Aïssa Mamadoultaibou; Victor M Aguayo
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Food and nutrition bulletin     Volume:  28     ISSN:  0379-5721     ISO Abbreviation:  Food Nutr Bull     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-11-02     Completed Date:  2008-01-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7906418     Medline TA:  Food Nutr Bull     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  317-27     Citation Subset:  IM    
Affiliation:
Nutrition Section, UNICEF-Niger, PO Box 12 481, 2, Rue de l'Oasis, Niamey, Niger. nzagre@unicef.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Birth Weight / drug effects*
Cluster Analysis
Dietary Supplements*
Double-Blind Method
Female
Folic Acid / administration & dosage*
Humans
Infant, Low Birth Weight
Infant, Newborn
Iron, Dietary / administration & dosage*
Male
Micronutrients
Niger
Nutritional Status
Pregnancy
Pregnancy Complications / prevention & control
Pregnancy Outcome
Prenatal Nutritional Physiological Phenomena / physiology*
Chemical
Reg. No./Substance:
0/Iron, Dietary; 0/Micronutrients; 59-30-3/Folic Acid

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