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Antenatal Micronutrient Supplements Don't Reduce Mortality

In Bangladesh, no reduction in all-cause mortality to age 6 months versus iron-folic acid supplement

WEDNESDAY, Dec. 24, 2014 (HealthDay News) -- In Bangladesh, antenatal multiple micronutrient supplementation is not associated with a reduction in all-cause mortality to age 6 months compared with iron-folic acid supplementation, according to a study published in the Dec. 24/31 issue of the Journal of the American Medical Association.

Keith P. West Jr., Dr.P.H., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues conducted a cluster-randomized trial in Bangladesh to examine the effects of antenatal multiple micronutrient versus iron-folic acid supplementation. Data were included for 22,405 pregnancies and 14,374 live-born infants in the multiple micronutrient group and for 22,162 pregnancies and 14,142 live-born infants in the iron-folic acid group.

The researchers observed no significant reduction in infant mortality at 6 months in the multiple micronutrient group, with 54.0 and 51.6 per 1,000 live births in the iron-folic acid and multiple micronutrient groups, respectively (relative risk, 0.95; 95 percent confidence interval, 0.86 to 1.06). There was a non-statistically significant reduction in stillbirths with multiple micronutrient supplementation (43.1 versus 48.2 per 1,000 births; relative risk, 0.89; 95 percent confidence interval, 0.81 to 0.99; P = 0.02); significant reductions were seen in preterm births and low birth weight (both P < 0.001) with multiple micronutrient supplementation.

"In Bangladesh, antenatal multiple micronutrient compared with iron-folic acid supplementation did not reduce all-cause infant mortality to age 6 months," the authors write.

Several authors disclosed financial ties to DSM, which formulated, prepared, and delivered in-country micronutrient premixes for supplement production free of charge. Beximco Pharmaceuticals provided study tablets free of charge.

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