Multiple micronutrient supplementation during pregnancy in low-income countries: A meta-analysis of effects on stillbirths and on early and late neonatal mortality

Research output: Contribution to journalJournal articleResearchpeer-review

  • Carine Ronsmans
  • David J. Fisher
  • Clive Osmond
  • Barrie Margetts
  • Caroline Fall
  • Pierre Adou
  • Victor M. Aguayo
  • Lindsay H. Allen
  • Zulfiqar Ahmed Bhutta
  • Parul Christian
  • Shaonong Dang
  • Gwenola Desplats
  • Michael Dibley
  • Shams El Arifeen
  • Caroline Fall
  • David Fisher
  • Exnenia Gomo
  • Batool Azra Haider
  • Adi Hidayat
  • Abbas Jahari
  • Pernille Kaes-tel
  • Patrick Kolsteren
  • Kusharisupeni
  • Aissa Mamadoultaibou
  • Dharma Sharna Manandhar
  • Barrie Margetts
  • David Osrin
  • Lars Ake Persson
  • Usha Ramakrishnan
  • Domi Nique Roberfroid
  • Carine Ronsmans
  • Anuraj H. Shankar
  • Subarkah
  • Sunawang
  • Budi Utomo
  • Anjana Vaidya
  • Hong Yan
  • Noel Zagre
  • Lingxia Zeng

Background: Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes Objective. To conduct a meta-analysis of the effects on stillbirths and on early and late neonatal mortality of supplementation during pregnancy with multiple micronutrients compared with iron-folic acid in recent randomized, controlled trials. 

Methods: Twelve randomized, controlled trials were included in the analysis (Bangladesh; Burkina Faso; China; Guinea-Bissau; lndramayu and Lombok, Indo-nesia; Mexico; Sarlahi and Janakur, Nepal; Niger; Pakistan; and Zimbabwe), all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients or iron-folic acid to presumed HIV-negative women. 

Results: Supplementation providing approximately 1 RDA of multiple micronutrients did not decrease the risk of stillbirth (OR = 1.01; 95% CI, 0.88 to 1.16), early neo-natal mortality (OR = 1.23; 95% CI, 0.95 to 1.59), late neonatal mortality (OR = 0.94; 95% CI, 0.73 to 1.23), or perinatal mortality (OR = 1.11; 95% CI, 0.93 to 1.33). 

Conclusions: Our meta-analysis provides consistent evidence that supplementation providing approximately 1 RDA of multiple micronutrients during pregnancy does not result in any reduction in stillbirths or in early or late neonatal deaths compared with iron-folic acid alone.

Original languageEnglish
JournalFood and Nutrition Bulletin
Volume30
Issue number4 (Supplement)
Pages (from-to)S547-S555
ISSN0379-5721
DOIs
Publication statusPublished - 2009

ID: 232082906