Impact of micronutrient supplementation during pregnancy on birth weight, duration of gestation, and perinatal mortality in rural western China: double blind cluster randomised controlled trial
2008

Impact of Micronutrient Supplementation During Pregnancy on Birth Outcomes in Rural China

Sample size: 5828 publication 10 minutes Evidence: moderate

Author Information

Author(s): Zeng Lingxia, Cheng Yue, Dang Shaonong, Yan Hong, Dibley Michael J, Chang Suying, Kong Lingzhi

Primary Institution: Xi’an Jiaotong University College of Medicine

Hypothesis

Does antenatal supplementation with multiple micronutrients or iron and folic acid improve birth weight, duration of gestation, and maternal haemoglobin concentration compared to folic acid alone?

Conclusion

Antenatal supplementation with iron-folic acid was associated with longer gestation and reduced early neonatal mortality compared to folic acid alone, while multiple micronutrients modestly increased birth weight but did not significantly reduce early neonatal mortality.

Supporting Evidence

  • Birth weight was 42 g higher in the multiple micronutrients group compared to the folic acid group.
  • Duration of gestation was longer in both the iron-folic acid and multiple micronutrients groups compared to folic acid.
  • Iron-folic acid was associated with a significant reduction in early preterm delivery.
  • Both iron-folic acid and multiple micronutrients significantly increased maternal haemoglobin concentration compared to folic acid alone.
  • Iron-folic acid supplementation reduced early neonatal mortality by 54% compared to folic acid.

Takeaway

Giving pregnant women extra vitamins and minerals can help babies be born healthier and stay alive longer, especially when they get iron and folic acid.

Methodology

A double blind cluster randomised controlled trial was conducted in two rural counties in China, with pregnant women receiving different supplementation regimens.

Potential Biases

Potential bias in outcome data collection as it was conducted by local health service staff.

Limitations

The study had low power to detect changes in perinatal mortality and relied on post hoc analyses for mortality outcomes.

Participant Demographics

Participants were 5828 pregnant women from socioeconomically disadvantaged rural areas in China.

Statistical Information

P-Value

P=0.031 for early preterm delivery, P=0.001 for haemoglobin increase with iron-folic acid, P<0.001 for haemoglobin increase with multiple micronutrients.

Confidence Interval

95% confidence interval for birth weight increase was 7 to 78 g.

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1136/bmj.a2001

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