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Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
Published on: June 28, 2024
Multiple-micronutrient supplementation for women during pregnancy
1The Aga Khan University Hospital, Department of Paediatrics, PO Box 3500, Stadium Road, Karachi, Pakistan.
The Cochrane Database of Systematic Reviews
|October 21, 2006
Summary
Multiple-micronutrient supplements (MMS) during pregnancy reduced low birthweight and maternal anemia compared to placebo. However, MMS showed no added benefit over iron-folic acid alone, and more research is needed on safety and efficacy.
Area of Science:
- Maternal and Child Health
- Nutritional Epidemiology
- Evidence Synthesis
Background:
- Multiple-micronutrient deficiencies are prevalent in low- to middle-income countries, posing risks during pregnancy.
- Increased nutritional demands in pregnancy can exacerbate deficiencies, potentially harming mothers and infants.
- Limited evidence exists on the effectiveness of multiple-micronutrient supplements (MMS) in pregnancy.
Purpose of the Study:
- To assess the benefits of MMS for mothers and infants during pregnancy.
- To evaluate the risks associated with excess supplementation and potential micronutrient interactions.
Main Methods:
- Systematic review of prospective randomized controlled trials (RCTs) identified from the Cochrane Pregnancy and Childbirth Group's Trials Register.
- Included nine RCTs involving 15,378 women evaluating micronutrient supplementation during pregnancy.
- Independent assessment of trial quality and data extraction by two review authors.
Main Results:
- MMS significantly decreased low birthweight (RR 0.83) and small-for-gestational-age babies (RR 0.92) compared to placebo or minimal supplementation.
- MMS also significantly reduced maternal anemia (RR 0.61) compared to placebo or minimal supplementation.
- No significant differences in preterm births or perinatal mortality were observed. Benefits diminished when compared to iron-folic acid alone; data on adverse effects were insufficient.
Conclusions:
- Current evidence is insufficient to recommend replacing iron and folate supplementation with MMS.
- While MMS showed benefits against placebo, no added advantage was found compared to iron-folic acid supplementation.
- Further research is required to determine optimal MMS use, potential adverse effects, and interactions during pregnancy.
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