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Is Oral Iron and Folate Supplementation during Pregnancy Protective against Low Birth Weight and Preterm Birth in
Yibeltal Bekele1,2, Claire Gallagher3, Mehak Batra1
1School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
Insights
Iron and iron-folic acid supplementation effectively reduces low birth weight in Africa. Evidence also suggests a potential decrease in preterm births, warranting further research in vulnerable populations.
Area of Science:
- Maternal and child health
- Nutritional epidemiology
- Public health interventions in Africa
Background:
- Iron and folate supplementation are known to reduce low birth weight and preterm births.
- Evidence synthesis on their impact in Africa is limited.
- Understanding these effects is crucial for improving maternal and infant outcomes in the region.
Purpose of the Study:
- To synthesize evidence on the impact of iron-only, folate-only, and iron-folic acid supplementation during pregnancy on low birth weight and preterm births in Africa.
- To evaluate the effectiveness of these interventions in the African context.
Main Methods:
- Comprehensive literature search across multiple databases (MEDLINE, PsycINFO, Embase, Scopus, CHINAL, Web of Science, Cochrane, Google Scholar).
- Inclusion of published and grey literature focusing on oral supplementation during pregnancy.
- Application of qualitative synthesis, meta-analysis, and subgroup analysis.
Main Results:
- Qualitative synthesis indicated that iron-folic acid supplementation positively impacts preterm birth reduction.
- Meta-analysis revealed significant reductions in low birth weight: 63% odds reduction with iron-folic acid and 68% with iron-only supplementation.
- Iron-only and iron-folic acid supplementation demonstrated effectiveness in lowering low birth weight risks.
Conclusions:
- Both iron-only and iron-folic acid supplementation are effective strategies for reducing low birth weight in African populations.
- Promising evidence suggests these supplements may also reduce preterm births.
- Further research is recommended, especially for high-risk groups in rural areas with limited support and literacy.
Background:
Despite recent evidence demonstrating iron and folate supplementation reduces the risk of low birth weight and preterm births, synthesis of the evidence is not sufficient to understand their impacts in Africa.
Method:
MEDLINE, PsycINFO, Embase, Scopus, CHINAL, Web of Science, Cochrane databases, and Google Scholar were searched for the published and grey literature. Either iron-only, folate-only, or iron-folic acid (IFA) oral supplementation during pregnancy was the primary exposure/intervention. The focus of this review was low birth weight and preterm births in the African region. Qualitative synthesis, meta-analysis, and subgroup analysis were employed.
Results:
In the qualitative synthesis (n = 4), IFA supplementation showed a positive impact on reducing preterm birth. Additionally, the meta-analysis showed that IFA and iron-only supplementation reduced the odds of low birth weight by 63% (OR 0.37; 95% CI: 0.29, 0.48) and 68% (OR 0.32; 95% CI: 0.21 to 0.50), respectively.
Conclusion:
Both iron-only and IFA supplementation are effective in reducing the risk of low birth weight in Africa. There is also promising evidence suggesting a potential reduction in preterm births. Consequently, further research is needed, particularly targeting high-risk groups such as women residing in rural areas with limited support and low levels of literacy.
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