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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
Batool A Haider1, Zulfiqar A Bhutta
1Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA, USA.
The Cochrane Database of Systematic Reviews
|November 16, 2012
Summary
Multiple-micronutrient supplements (MMS) during pregnancy significantly reduced low birthweight and small-for-gestational age (SGA) babies compared to iron and folate alone. More evidence is needed to guide universal policy changes for MMS.
Area of Science:
- Obstetrics and Gynecology
- Maternal and Child Health
- Nutritional Science
Background:
- Multiple-micronutrient deficiencies are common in low- to middle-income countries and are worsened during pregnancy.
- Increased nutritional demands in pregnancy can lead to adverse maternal outcomes.
- Limited evidence exists on the effectiveness of multiple-micronutrient supplements (MMS) during pregnancy.
Purpose of the Study:
- To evaluate the maternal and infant benefits of MMS during pregnancy.
- To assess the risks of adverse events associated with MMS supplementation.
Main Methods:
- Systematic review of prospective randomized controlled trials (RCTs) identified through Cochrane Pregnancy and Childbirth Group's Trials Register and expert contact.
- Included 21 trials with 75,785 women, comparing MMS with iron and folate supplementation.
- Independent assessment of trial eligibility, quality, and data extraction by two reviewers.
Main Results:
- MMS significantly decreased the incidence of low birthweight babies (RR 0.89; 95% CI 0.83 to 0.94) and small-for-gestational age (SGA) babies (RR 0.87; 95% CI 0.81 to 0.95) compared to iron and folate.
- No significant differences were observed for preterm births, miscarriage, maternal mortality, perinatal mortality, stillbirths, or neonatal mortality.
- Insufficient data prevented assessment of other important outcomes like congenital anomalies, neurodevelopmental delay, and maternal well-being.
Conclusions:
- MMS demonstrate a significant benefit in reducing SGA and low birthweight babies.
- Further adequately powered trials are required to assess effects on mortality and morbidity outcomes.
- More research is needed on optimal MMS combinations and dosages, and their impact on routine antenatal care policies.
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