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Early Addition of Prenatal Micronutrients Ups Child Survival

Micronutrients, including iron and folic acid, with food supplements cut infant deaths in Bangladeshi women

TUESDAY, May 15 (HealthDay News) -- Poor, pregnant women who receive multiple micronutrient supplementation (MMS), including iron and folic acid, with early food supplementation, have substantially improved infant survival, compared to women in a standard program, according to a study published in the May 16 issue of the Journal of the American Medical Association, a theme issue on global health.

Lars Åke Persson, M.D., Ph.D., from University Hospital in Uppsala, Sweden, and colleagues conducted a trial in which 4,436 pregnant women in Bangladesh were randomized to receive the following: capsules of 30 mg of iron and 400 µg of folic acid; 60 mg of iron and 400 µg of folic acid; or MMS containing a daily allowance of 15 micronutrients (including 30 mg of iron and 400 µg of folic acid), combined with food supplementation. Each of these options was offered at either early invitation (nine weeks of gestation) or usual invitation (20 weeks of gestation).

The researchers found that there were 3,625 live births out of 4,436 pregnancies. The early-invitation MMS group had a lower infant mortality rate compared to the usual invitation with 60 mg of iron and 400 µg of folic acid (16.8 versus 44.1 per 1,000 live births; hazard ratio [HR], 0.38, 95 percent confidence interval [CI], 0.18 to 0.78). The under five-year mortality rate for the early-invitation MMS group was lower than the usual invitation with 60 mg of iron and 400 µg of folic acid group (18 versus 54 per 1,000 live births; HR, 0.34, 95 percent CI, 0.18 to 0.65). The highest incidence of spontaneous abortions and the highest infant mortality rate was observed in the usual invitation with MMS group.

"Among pregnant women in poor communities in Bangladesh, treatment with multiple micronutrients, including iron and folic acid combined with early food supplementation, versus a standard program that included treatment with iron and folic acid and usual food supplementation, resulted in decreased childhood mortality," the authors write.

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