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Multiple-micronutrient supplementation for women during pregnancy
Batool A Haider1, Zulfiqar A Bhutta2
1Department of Global Health and Population, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, USA, 02115.
The Cochrane Database of Systematic Reviews
|April 14, 2017
Summary
Multiple-micronutrient (MMN) supplements containing iron and folic acid reduce low birthweight and small-for-gestational-age babies in pregnant women. This supports replacing standard iron and folic acid supplements with MMNs in low-resource settings.
Area of Science:
- Maternal and Fetal Health
- Nutritional Science
- Public Health Interventions
Background:
- Multiple-micronutrient (MMN) deficiencies are common in women of reproductive age in low- to middle-income countries.
- Pregnancy exacerbates MMN deficiencies, posing risks to mother and fetus.
- Consensus is lacking on replacing iron and folic acid with MMN supplementation during pregnancy.
Purpose of the Study:
- To evaluate the benefits of oral MMN supplementation during pregnancy.
- To assess effects on maternal, fetal, and infant health outcomes.
- To inform policy regarding MMN supplementation in pregnancy.
Main Methods:
- Systematic review of prospective randomized controlled trials.
- Inclusion of 17 trials with 137,791 women.
- Data extraction and risk of bias assessment using GRADE approach.
Main Results:
- MMN supplementation significantly decreased low birthweight (LBW) and small-for-gestational-age (SGA) infants.
- High-quality evidence supports MMNs for reducing LBW; moderate for SGA.
- No significant differences observed for preterm birth, stillbirth, or maternal mortality.
Conclusions:
- MMN supplements with iron and folic acid improve certain birth outcomes, notably reducing LBW and SGA.
- Findings support replacing iron and folic acid with MMNs in high-risk populations.
- Integration into maternal nutrition and antenatal care programs is recommended.