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 M. Margetts; Caroline H.D. Fall; Pierre Adou; Victor M. Aguayo; Lindsay H. Allen; Zulfiqar Ahmed Bhutta; Parul Christian; Shaonong Dang; Gwenola Desplats; Michael Dibley; Shams El Arifeen; Henrik Friis; 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; Anuraj H. Shankar; Subarkah; Sunawang; Budi Utomo; Anjana Vaidya; Hong Yan; Noel Zagre; Lingxia Zeng

doi:10.1177/15648265090304s409

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

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

56 Scopus citations

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 (US)
Pages (from-to)	S547-S555
Journal	Food and nutrition bulletin
Volume	30
Issue number	4
DOIs	https://doi.org/10.1177/15648265090304s409
State	Published - Dec 2009

ASJC Scopus subject areas

Food Science
Geography, Planning and Development
Nutrition and Dietetics

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Ronsmans, C., Fisher, D. J., Osmond, C., Margetts, B. M., Fall, C. H. D., Adou, P., Aguayo, V. M., Allen, L. H., Bhutta, Z. A., Christian, P., Dang, S., Desplats, G., Dibley, M., Arifeen, S. E., Friis, H., Gomo, E., Haider, B. A., Hidayat, A., Jahari, 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), S547-S555. https://doi.org/10.1177/15648265090304s409

Ronsmans, C, Fisher, DJ, Osmond, C, Margetts, BM, Fall, CHD, Adou, P, Aguayo, VM, Allen, LH, Bhutta, ZA, Christian, P, Dang, S, Desplats, G, Dibley, M, Arifeen, SE, 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, 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, pp. S547-S555. https://doi.org/10.1177/15648265090304s409

@article{198dfa0842ae465fa04bc02d046f1b6a,

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 Margetts, {Barrie M.} and Fall, {Caroline H.D.} 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 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 Shankar, {Anuraj H.} and Subarkah and Sunawang and Budi Utomo and Anjana Vaidya and Hong Yan and Noel Zagre and Lingxia Zeng",

year = "2009",

month = dec,

doi = "10.1177/15648265090304s409",

language = "English (US)",

volume = "30",

pages = "S547--S555",

journal = "Food and nutrition bulletin",

issn = "0379-5721",

publisher = "United Nations University Press",

number = "4",

}

TY - JOUR

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 M.

AU - Fall, Caroline H.D.

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 - Friis, Henrik

AU - Gomo, Exnenia

AU - Haider, Batool Azra

AU - Hidayat, Adi

AU - Jahari, Abbas

AU - Kaes-tel, Pernille

AU - Kolsteren, Patrick

AU - Kusharisupeni,

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 - Shankar, Anuraj H.

AU - Subarkah,

AU - Sunawang,

AU - Utomo, Budi

AU - Vaidya, Anjana

AU - Yan, Hong

AU - Zagre, Noel

AU - Zeng, Lingxia

PY - 2009/12

Y1 - 2009/12

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

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