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

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; Henrik Friis; Exnenia Gomo; Batool Azra Haider; Adi Hidayat; Abbas Jahari; Pernille Kaes-tel; Patrick Kolsteren; null Kusharisupeni; Aissa Mamadoultaibou; Dharma Sharna Manandhar; Barrie Margetts; David Osrin; Lars Ake Persson; Usha Ramakrishnan; Domi Nique Roberfroid; Carine Ronsmans; Anuraj H. Shankar; null Subarkah; null Sunawang; Budi Utomo; Anjana Vaidya; Hong Yan; Noel Zagre; Lingxia Zeng

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

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, Henrik Friis, Exnenia Gomo, Batool Azra Haider, Adi HidayatAbbas 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

Lifecourse Nutrition & Health

56 Citations (Scopus)

Abstract

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 language	English
Journal	Food and Nutrition Bulletin
Volume	30
Issue number	4 SUPPL.
Pages (from-to)	S547-S555
ISSN	0379-5721
Publication status	Published - 1 Dec 2009

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Ronsmans, C., Fisher, D. J., Osmond, C., Margetts, B., Fall, C., Adou, P., Aguayo, V. M., Allen, L. H., Bhutta, Z. A., Christian, P., Dang, S., Desplats, G., Dibley, M., Arifeen, S. E., Fall, C., Fisher, D., Friis, H., Gomo, E., Haider, B. A., ... Zeng, L. (2009). Multiple micronutrient supplementation during pregnancy in low-income countries: A meta-analysis of effects on stillbirths and on early and late neonatal mortality. Food and Nutrition Bulletin, 30(4 SUPPL.), S547-S555.

Multiple micronutrient supplementation during pregnancy in low-income countries : A meta-analysis of effects on stillbirths and on early and late neonatal mortality. / Ronsmans, Carine; Fisher, David J.; Osmond, Clive et al.

In: Food and Nutrition Bulletin, Vol. 30, No. 4 SUPPL., 01.12.2009, p. S547-S555.

Research output: Contribution to journal › Journal article › Research › peer-review

Ronsmans, C, Fisher, DJ, Osmond, C, Margetts, B, Fall, C, Adou, P, Aguayo, VM, Allen, LH, Bhutta, ZA, Christian, P, Dang, S, Desplats, G, Dibley, M, Arifeen, SE, Fall, C, Fisher, D, Friis, H, Gomo, E, Haider, BA, Hidayat, A, Jahari, A, Kaes-tel, P, Kolsteren, P, Kusharisupeni, Mamadoultaibou, A, Manandhar, DS, Margetts, B, Osrin, D, Persson, LA, Ramakrishnan, U, Roberfroid, DN, Ronsmans, C, Shankar, AH, Subarkah, Sunawang, Utomo, B, Vaidya, A, Yan, H, Zagre, N & Zeng, L 2009, 'Multiple micronutrient supplementation during pregnancy in low-income countries: A meta-analysis of effects on stillbirths and on early and late neonatal mortality', Food and Nutrition Bulletin, vol. 30, no. 4 SUPPL., pp. S547-S555.

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

abstract = "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.",

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

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T1 - Multiple micronutrient supplementation during pregnancy in low-income countries

T2 - A meta-analysis of effects on stillbirths and on early and late neonatal mortality

AU - Ronsmans, Carine

AU - Fisher, David J.

AU - Osmond, Clive

AU - Margetts, Barrie

AU - Fall, Caroline

AU - Adou, Pierre

AU - Aguayo, Victor M.

AU - Allen, Lindsay H.

AU - Bhutta, Zulfiqar Ahmed

AU - Christian, Parul

AU - Dang, Shaonong

AU - Desplats, Gwenola

AU - Dibley, Michael

AU - Arifeen, Shams El

AU - Fall, Caroline

AU - Fisher, David

AU - Friis, Henrik

AU - Gomo, Exnenia

AU - Haider, Batool Azra

AU - Hidayat, Adi

AU - Jahari, Abbas

AU - Kaes-tel, Pernille

AU - Kolsteren, Patrick

AU - Kusharisupeni, null

AU - Mamadoultaibou, Aissa

AU - Manandhar, Dharma Sharna

AU - Margetts, Barrie

AU - Osrin, David

AU - Persson, Lars Ake

AU - Ramakrishnan, Usha

AU - Roberfroid, Domi Nique

AU - Ronsmans, Carine

AU - Shankar, Anuraj H.

AU - Subarkah, null

AU - Sunawang, null

AU - Utomo, Budi

AU - Vaidya, Anjana

AU - Yan, Hong

AU - Zagre, Noel

AU - Zeng, Lingxia

PY - 2009/12/1

Y1 - 2009/12/1

N2 - 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.

AB - 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.

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M3 - Journal article

C2 - 20120796

AN - SCOPUS:76749118585

SN - 0379-5721

VL - 30

SP - S547-S555

JO - Food and Nutrition Bulletin

JF - Food and Nutrition Bulletin

IS - 4 SUPPL.

ER -

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

Abstract

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