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

Carine Ronsmans, David J. Fisher, Clive Osmond, Barrie M. Margetts, Caroline H.D. Fall, Pierre Adou, Victor M. Aguayo, Lindsay H. Allen, Zulfiqar Ahmed Bhutta, Parul Christian, Shaonong Dang, Gwenola Desplats, Michael Dibley, Shams El Arifeen, Caroline Fall, David Fisher, Henrik Friis, Exnenia Gomo, Batool Azra Haider, Adi HidayatAbbas Jahari, Pernille Kaes-tel, Patrick Kolsteren, Kusharisupeni, Aissa Mamadoultaibou, Dharma Sharna Manandhar, Barrie Margetts, David Osrin, Lars Ake Persson, Usha Ramakrishnan, Domi Nique Roberfroid, Carine Ronsmans, Anuraj H. Shankar, Subarkah, Sunawang, Budi Utomo, Anjana Vaidya, Hong Yan, Noel Zagre, Lingxia Zeng

Research output: Contribution to journalArticle

Abstract

Background. Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes 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. Methods. Twelve randomized, controlled trials were included in the analysis (Bangladesh; Burkina Faso; China; Guinea-Bissau; lndramayu and Lombok, Indo-nesia; 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. Results. Supplementation providing approximately 1 RDA of multiple micronutrients did not decrease the risk of stillbirth (OR = 1.01; 95% CI, 0.88 to 1.16), early neo-natal 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). 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.

Original languageEnglish (US)
Pages (from-to)S547-S555
JournalFood and nutrition bulletin
Volume30
Issue number4 SUPPL.
StatePublished - Dec 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Food Science
  • Geography, Planning and Development
  • Nutrition and Dietetics

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    Ronsmans, C., Fisher, D. J., Osmond, C., Margetts, B. M., Fall, C. H. D., Adou, P., Aguayo, V. M., Allen, L. H., Bhutta, Z. A., Christian, P., Dang, S., Desplats, G., Dibley, M., Arifeen, S. E., Fall, C., Fisher, D., Friis, H., Gomo, E., Haider, B. A., ... 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-S555.