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
Objective To examine the impact of antenatal supplementation with multiple micronutrients or iron and folic acid compared with folic acid alone on birth weight, duration of gestation, and maternal haemoglobin concentration in the third trimester.Design Cluster randomised double blind controlled tria...
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| creator | Zeng, Lingxia Cheng, Yue Dang, Shaonong Yan, Hong Dibley, Michael J Chang, Suying Kong, Lingzhi |
| description | Objective To examine the impact of antenatal supplementation with multiple micronutrients or iron and folic acid compared with folic acid alone on birth weight, duration of gestation, and maternal haemoglobin concentration in the third trimester.Design Cluster randomised double blind controlled trial.Setting Two rural counties in north west China.Participants 5828 pregnant women and 4697 live births.Interventions Villages were randomised for all pregnant women to take either daily folic acid (control), iron with folic acid, or multiple micronutrients with a recommended allowance of 15 vitamins and minerals.Main outcome measures Birth weight, length, and head circumference measured within 72 hours after delivery. Neonatal survival assessed at the six week follow-up visit.Results Birth weight was 42 g (95% confidence interval 7 to 78 g) higher in the multiple micronutrients group compared with the folic acid group. Duration of gestation was 0.23 weeks (0.10 to 0.36 weeks) longer in the iron-folic acid group and 0.19 weeks (0.06 to 0.32 weeks) longer in the multiple micronutrients group. Iron-folic acid was associated with a significantly reduced risk of early preterm delivery ( |
| doi_str_mv | 10.1136/bmj.a2001 |
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| fullrecord | <record><control><sourceid>jstor_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2577799</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>20511389</jstor_id><sourcerecordid>20511389</sourcerecordid><originalsourceid>FETCH-LOGICAL-b578t-cbfbf148110cd458dea71c537ec92ab7fd62ef70da71f2b8b74dbdeb0cc126ee3</originalsourceid><addsrcrecordid>eNqFkttu1DAQhiMEolXpBQ8AsjhJSN1iO4kPXCChFSyVCtwUbi3HcXa9OHZwEmAfjzdjQlZLQaq4sjXzze-Z8Z9l9wk-JyRnL6p2e64pxuRWdkwKJhalyPPb2TGWpVwIkouj7LTvtxhjmnMhWXk3OyJCSiZzfJz9vGg7bQYUG9Q6k2IYh-RsGFA_dp23LVz14GJA9ZhcWKMu2XXQwewQxCqXhg36bt16M5xNxIyC1tr2c90Z0qFGnYViPWiP2pjgcMMOuYASVHio7webAlpugHmJ6jhW3qLKOyg0fpySKIFKbF1vIRTDkKL3cIVWtb-X3Wm07-3p_jzJPr19c7V8t7j8uLpYvr5cVCUXw8JUTdWQQhCCTV2UoraaE1Pm3BpJdcWbmlHbcFxDuKGVqHhRV7WtsDGEMmvzk-zVrNuNVWtrA5uB7lWXXKvTTkXt1N-Z4DZqHb8pWnLOpQSBZ3uBFL-OMLSCgYz1Xgcbx14xyTmVhP0XLDktJGcUwEf_gNs4pgBbUBQXmLKSEYAe3wQRzgVmRBaT1POZAg_0fbLNYTCC1eQzBT5Tv30G7MPrm_hD7l0FwNM9oHujfQO_Z1x_4CgWBaNi4h7M3LYfYrqWL-FFMW1sMecdmODHIa_TF8V4zkv14fNSifz9SvLVlZoW92Tmp15v7v8XLcgGLg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1778061942</pqid></control><display><type>article</type><title>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</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>JSTOR Archive Collection A-Z Listing</source><source>Alma/SFX Local Collection</source><creator>Zeng, Lingxia ; Cheng, Yue ; Dang, Shaonong ; Yan, Hong ; Dibley, Michael J ; Chang, Suying ; Kong, Lingzhi</creator><creatorcontrib>Zeng, Lingxia ; Cheng, Yue ; Dang, Shaonong ; Yan, Hong ; Dibley, Michael J ; Chang, Suying ; Kong, Lingzhi</creatorcontrib><description>Objective To examine the impact of antenatal supplementation with multiple micronutrients or iron and folic acid compared with folic acid alone on birth weight, duration of gestation, and maternal haemoglobin concentration in the third trimester.Design Cluster randomised double blind controlled trial.Setting Two rural counties in north west China.Participants 5828 pregnant women and 4697 live births.Interventions Villages were randomised for all pregnant women to take either daily folic acid (control), iron with folic acid, or multiple micronutrients with a recommended allowance of 15 vitamins and minerals.Main outcome measures Birth weight, length, and head circumference measured within 72 hours after delivery. Neonatal survival assessed at the six week follow-up visit.Results Birth weight was 42 g (95% confidence interval 7 to 78 g) higher in the multiple micronutrients group compared with the folic acid group. Duration of gestation was 0.23 weeks (0.10 to 0.36 weeks) longer in the iron-folic acid group and 0.19 weeks (0.06 to 0.32 weeks) longer in the multiple micronutrients group. Iron-folic acid was associated with a significantly reduced risk of early preterm delivery (<34 weeks) (relative risk 0.50, 0.27 to 0.94, P=0.031). There was a significant increase in haemoglobin concentration in both iron-folic acid (5.0 g/l, 2.0 to 8.0 g/l, P=0.001) and multiple micronutrients (6.9 g/l, 4.1 to 9.6 g/l, P<0.001) groups compared with folic acid alone. In post hoc analyses there were no significant differences for perinatal mortality, but iron-folic acid was associated with a significantly reduced early neonatal mortality by 54% (relative risk 0.46, 0.21 to 0.98).Conclusion In rural populations in China antenatal supplementation with iron-folic acid was associated with longer gestation and a reduction in early neonatal mortality compared with folic acid. Multiple micronutrients were associated with modestly increased birth weight compared with folic acid, but, despite this weight gain, there was no significant reduction in early neonatal mortality. Pregnant women in developing countries need sufficient doses of iron in nutrient supplements to maximise reductions in neonatal mortality.Trial registration ISRCTN08850194.</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>ISSN: 0959-535X</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.a2001</identifier><identifier>PMID: 18996930</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Birth Weight ; Births ; China ; Clinical trials ; Cluster Analysis ; Developing countries ; Dietary Supplements ; Diseases of mother, fetus and pregnancy ; Double-Blind Method ; Epidemiology ; Female ; General aspects ; Gestation period ; Gestational Age ; Gynecology. Andrology. Obstetrics ; Hemoglobins - metabolism ; Humans ; Infant mortality ; Infants ; Iron ; LDCs ; Low birth weight ; Medical sciences ; Micronutrients ; Micronutrients - administration & dosage ; Mortality ; Neonatal care ; Neonatal mortality ; Newborn babies ; Nutrition Disorders - therapy ; Patient Compliance ; Perinatal Mortality ; Pregnancy ; Pregnancy Complications - therapy ; Pregnancy Outcome ; Pregnancy. Fetus. Placenta ; Pregnant women ; Prenatal care ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Rural Health ; Supplements ; Vitamin B ; Womens health</subject><ispartof>BMJ, 2008-11, Vol.337 (7680), p.1211-1215</ispartof><rights>Zeng et al 2008</rights><rights>Copyright 2008 BMJ Publishing Group Ltd.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright BMJ Publishing Group LTD Nov 7, 2008</rights><rights>Copyright BMJ Publishing Group Nov 22, 2008</rights><rights>Zeng et al 2008 2008 Zeng et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b578t-cbfbf148110cd458dea71c537ec92ab7fd62ef70da71f2b8b74dbdeb0cc126ee3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/337/bmj.a2001.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmj.com/content/337/bmj.a2001.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,315,781,785,804,886,3197,23576,27929,27930,31004,31005,58022,58255,77605,77636</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20846280$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18996930$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zeng, Lingxia</creatorcontrib><creatorcontrib>Cheng, Yue</creatorcontrib><creatorcontrib>Dang, Shaonong</creatorcontrib><creatorcontrib>Yan, Hong</creatorcontrib><creatorcontrib>Dibley, Michael J</creatorcontrib><creatorcontrib>Chang, Suying</creatorcontrib><creatorcontrib>Kong, Lingzhi</creatorcontrib><title>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</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Objective To examine the impact of antenatal supplementation with multiple micronutrients or iron and folic acid compared with folic acid alone on birth weight, duration of gestation, and maternal haemoglobin concentration in the third trimester.Design Cluster randomised double blind controlled trial.Setting Two rural counties in north west China.Participants 5828 pregnant women and 4697 live births.Interventions Villages were randomised for all pregnant women to take either daily folic acid (control), iron with folic acid, or multiple micronutrients with a recommended allowance of 15 vitamins and minerals.Main outcome measures Birth weight, length, and head circumference measured within 72 hours after delivery. Neonatal survival assessed at the six week follow-up visit.Results Birth weight was 42 g (95% confidence interval 7 to 78 g) higher in the multiple micronutrients group compared with the folic acid group. Duration of gestation was 0.23 weeks (0.10 to 0.36 weeks) longer in the iron-folic acid group and 0.19 weeks (0.06 to 0.32 weeks) longer in the multiple micronutrients group. Iron-folic acid was associated with a significantly reduced risk of early preterm delivery (<34 weeks) (relative risk 0.50, 0.27 to 0.94, P=0.031). There was a significant increase in haemoglobin concentration in both iron-folic acid (5.0 g/l, 2.0 to 8.0 g/l, P=0.001) and multiple micronutrients (6.9 g/l, 4.1 to 9.6 g/l, P<0.001) groups compared with folic acid alone. In post hoc analyses there were no significant differences for perinatal mortality, but iron-folic acid was associated with a significantly reduced early neonatal mortality by 54% (relative risk 0.46, 0.21 to 0.98).Conclusion In rural populations in China antenatal supplementation with iron-folic acid was associated with longer gestation and a reduction in early neonatal mortality compared with folic acid. Multiple micronutrients were associated with modestly increased birth weight compared with folic acid, but, despite this weight gain, there was no significant reduction in early neonatal mortality. Pregnant women in developing countries need sufficient doses of iron in nutrient supplements to maximise reductions in neonatal mortality.Trial registration ISRCTN08850194.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Birth Weight</subject><subject>Births</subject><subject>China</subject><subject>Clinical trials</subject><subject>Cluster Analysis</subject><subject>Developing countries</subject><subject>Dietary Supplements</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Double-Blind Method</subject><subject>Epidemiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Gestation period</subject><subject>Gestational Age</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Hemoglobins - metabolism</subject><subject>Humans</subject><subject>Infant mortality</subject><subject>Infants</subject><subject>Iron</subject><subject>LDCs</subject><subject>Low birth weight</subject><subject>Medical sciences</subject><subject>Micronutrients</subject><subject>Micronutrients - administration & dosage</subject><subject>Mortality</subject><subject>Neonatal care</subject><subject>Neonatal mortality</subject><subject>Newborn babies</subject><subject>Nutrition Disorders - therapy</subject><subject>Patient Compliance</subject><subject>Perinatal Mortality</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - therapy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Pregnant women</subject><subject>Prenatal care</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Rural Health</subject><subject>Supplements</subject><subject>Vitamin B</subject><subject>Womens health</subject><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkttu1DAQhiMEolXpBQ8AsjhJSN1iO4kPXCChFSyVCtwUbi3HcXa9OHZwEmAfjzdjQlZLQaq4sjXzze-Z8Z9l9wk-JyRnL6p2e64pxuRWdkwKJhalyPPb2TGWpVwIkouj7LTvtxhjmnMhWXk3OyJCSiZzfJz9vGg7bQYUG9Q6k2IYh-RsGFA_dp23LVz14GJA9ZhcWKMu2XXQwewQxCqXhg36bt16M5xNxIyC1tr2c90Z0qFGnYViPWiP2pjgcMMOuYASVHio7webAlpugHmJ6jhW3qLKOyg0fpySKIFKbF1vIRTDkKL3cIVWtb-X3Wm07-3p_jzJPr19c7V8t7j8uLpYvr5cVCUXw8JUTdWQQhCCTV2UoraaE1Pm3BpJdcWbmlHbcFxDuKGVqHhRV7WtsDGEMmvzk-zVrNuNVWtrA5uB7lWXXKvTTkXt1N-Z4DZqHb8pWnLOpQSBZ3uBFL-OMLSCgYz1Xgcbx14xyTmVhP0XLDktJGcUwEf_gNs4pgBbUBQXmLKSEYAe3wQRzgVmRBaT1POZAg_0fbLNYTCC1eQzBT5Tv30G7MPrm_hD7l0FwNM9oHujfQO_Z1x_4CgWBaNi4h7M3LYfYrqWL-FFMW1sMecdmODHIa_TF8V4zkv14fNSifz9SvLVlZoW92Tmp15v7v8XLcgGLg</recordid><startdate>20081107</startdate><enddate>20081107</enddate><creator>Zeng, Lingxia</creator><creator>Cheng, Yue</creator><creator>Dang, Shaonong</creator><creator>Yan, Hong</creator><creator>Dibley, Michael J</creator><creator>Chang, Suying</creator><creator>Kong, Lingzhi</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group Ltd</general><scope>9YT</scope><scope>ACMMV</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QJ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20081107</creationdate><title>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</title><author>Zeng, Lingxia ; Cheng, Yue ; Dang, Shaonong ; Yan, Hong ; Dibley, Michael J ; Chang, Suying ; Kong, Lingzhi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b578t-cbfbf148110cd458dea71c537ec92ab7fd62ef70da71f2b8b74dbdeb0cc126ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Birth Weight</topic><topic>Births</topic><topic>China</topic><topic>Clinical trials</topic><topic>Cluster Analysis</topic><topic>Developing countries</topic><topic>Dietary Supplements</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Double-Blind Method</topic><topic>Epidemiology</topic><topic>Female</topic><topic>General aspects</topic><topic>Gestation period</topic><topic>Gestational Age</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Hemoglobins - metabolism</topic><topic>Humans</topic><topic>Infant mortality</topic><topic>Infants</topic><topic>Iron</topic><topic>LDCs</topic><topic>Low birth weight</topic><topic>Medical sciences</topic><topic>Micronutrients</topic><topic>Micronutrients - administration & dosage</topic><topic>Mortality</topic><topic>Neonatal care</topic><topic>Neonatal mortality</topic><topic>Newborn babies</topic><topic>Nutrition Disorders - therapy</topic><topic>Patient Compliance</topic><topic>Perinatal Mortality</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - therapy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Pregnant women</topic><topic>Prenatal care</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Rural Health</topic><topic>Supplements</topic><topic>Vitamin B</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zeng, Lingxia</creatorcontrib><creatorcontrib>Cheng, Yue</creatorcontrib><creatorcontrib>Dang, Shaonong</creatorcontrib><creatorcontrib>Yan, Hong</creatorcontrib><creatorcontrib>Dibley, Michael J</creatorcontrib><creatorcontrib>Chang, Suying</creatorcontrib><creatorcontrib>Kong, Lingzhi</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeng, Lingxia</au><au>Cheng, Yue</au><au>Dang, Shaonong</au><au>Yan, Hong</au><au>Dibley, Michael J</au><au>Chang, Suying</au><au>Kong, Lingzhi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>BMJ</jtitle><addtitle>BMJ</addtitle><date>2008-11-07</date><risdate>2008</risdate><volume>337</volume><issue>7680</issue><spage>1211</spage><epage>1215</epage><pages>1211-1215</pages><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>Objective To examine the impact of antenatal supplementation with multiple micronutrients or iron and folic acid compared with folic acid alone on birth weight, duration of gestation, and maternal haemoglobin concentration in the third trimester.Design Cluster randomised double blind controlled trial.Setting Two rural counties in north west China.Participants 5828 pregnant women and 4697 live births.Interventions Villages were randomised for all pregnant women to take either daily folic acid (control), iron with folic acid, or multiple micronutrients with a recommended allowance of 15 vitamins and minerals.Main outcome measures Birth weight, length, and head circumference measured within 72 hours after delivery. Neonatal survival assessed at the six week follow-up visit.Results Birth weight was 42 g (95% confidence interval 7 to 78 g) higher in the multiple micronutrients group compared with the folic acid group. Duration of gestation was 0.23 weeks (0.10 to 0.36 weeks) longer in the iron-folic acid group and 0.19 weeks (0.06 to 0.32 weeks) longer in the multiple micronutrients group. Iron-folic acid was associated with a significantly reduced risk of early preterm delivery (<34 weeks) (relative risk 0.50, 0.27 to 0.94, P=0.031). There was a significant increase in haemoglobin concentration in both iron-folic acid (5.0 g/l, 2.0 to 8.0 g/l, P=0.001) and multiple micronutrients (6.9 g/l, 4.1 to 9.6 g/l, P<0.001) groups compared with folic acid alone. In post hoc analyses there were no significant differences for perinatal mortality, but iron-folic acid was associated with a significantly reduced early neonatal mortality by 54% (relative risk 0.46, 0.21 to 0.98).Conclusion In rural populations in China antenatal supplementation with iron-folic acid was associated with longer gestation and a reduction in early neonatal mortality compared with folic acid. Multiple micronutrients were associated with modestly increased birth weight compared with folic acid, but, despite this weight gain, there was no significant reduction in early neonatal mortality. Pregnant women in developing countries need sufficient doses of iron in nutrient supplements to maximise reductions in neonatal mortality.Trial registration ISRCTN08850194.</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>18996930</pmid><doi>10.1136/bmj.a2001</doi><tpages>5</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0959-8138 |
| ispartof | BMJ, 2008-11, Vol.337 (7680), p.1211-1215 |
| issn | 0959-8138 0959-8146 0959-535X 1468-5833 1756-1833 |
| language | eng |
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| source | MEDLINE; BMJ Journals - NESLi2; Applied Social Sciences Index & Abstracts (ASSIA); JSTOR Archive Collection A-Z Listing; Alma/SFX Local Collection |
| subjects | Adolescent Adult Biological and medical sciences Birth Weight Births China Clinical trials Cluster Analysis Developing countries Dietary Supplements Diseases of mother, fetus and pregnancy Double-Blind Method Epidemiology Female General aspects Gestation period Gestational Age Gynecology. Andrology. Obstetrics Hemoglobins - metabolism Humans Infant mortality Infants Iron LDCs Low birth weight Medical sciences Micronutrients Micronutrients - administration & dosage Mortality Neonatal care Neonatal mortality Newborn babies Nutrition Disorders - therapy Patient Compliance Perinatal Mortality Pregnancy Pregnancy Complications - therapy Pregnancy Outcome Pregnancy. Fetus. Placenta Pregnant women Prenatal care Public health. Hygiene Public health. Hygiene-occupational medicine Rural Health Supplements Vitamin B Womens health |
| title | 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 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-14T21%3A58%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20micronutrient%20supplementation%20during%20pregnancy%20on%20birth%20weight,%20duration%20of%20gestation,%20and%20perinatal%20mortality%20in%20rural%20western%20China:%20double%20blind%20cluster%20randomised%20controlled%20trial&rft.jtitle=BMJ&rft.au=Zeng,%20Lingxia&rft.date=2008-11-07&rft.volume=337&rft.issue=7680&rft.spage=1211&rft.epage=1215&rft.pages=1211-1215&rft.issn=0959-8138&rft.eissn=1468-5833&rft.coden=BMJOAE&rft_id=info:doi/10.1136/bmj.a2001&rft_dat=%3Cjstor_pubme%3E20511389%3C/jstor_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1778061942&rft_id=info:pmid/18996930&rft_jstor_id=20511389&rfr_iscdi=true |