Effects of maternal micronutrient supplementation on fetal loss and under-2-years child mortality: long-term follow-up of a randomised controlled trial from Guinea-Bissau.
A number of trials on maternal multi-micronutrient supplementation (MMS) have found a benefical effect on birth weight, but few have demonstrated a beneficial effect on infant survival. We examined the effect of two different preparations of antenatal MMS on fetal loss and under-2-years child mortality, as compared with iron-folic acid supplementation among 2,100 pregnant women in Guinea-Bissau. Women receiving a 1xRDA MMS preparation (consisting of 14 vitamins and minerals) had a marginally reduced risk of fetal loss (Relative risk (RR) 0.65, 95% CI 0.40; 1.05), and women receiving a 2xRDA MMS preparation had a similar effect (RR 0.67, 95% CI 0.42; 1.08), the pooled effect being 0.66 (95% CI 0.44; 0.99). None of the supplements reduced under-2-years mortality or the combination of fetal loss and under-2-years mortality. There was a marginally negative effect of both the 1xRDA (RR 2.10, 95% CI 0.99; 4.46) and the 2xRDA (RR 2.02, 95% CI 0.95; 4.32) MMS preparation on mortality specifically between 92-365 days of age.
Department of Human Nutrition, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark. gsa@life.ku.dk
Gregers Stig
GS
Andersen
Henrik
H
Friis
Kim Fleischer
KF
Michaelsen
Amabelia
A
Rodrigues
Christine Stabell
CS
Benn
Peter
P
Aaby
Pernille
P
Kaestel
D000328:Adult; D019587:Dietary Supplements; D005260:Female; D005313:Fetal Death / Q000517:prevention & control*; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007407:Interviews as Topic; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D016016:Proportional Hazards Models; D012306:Risk; D014131:Trace Elements / Q000008:administration & dosage / Q000627:therapeutic use*
D014131:Trace Elements; D005492:Folic Acid; D007501:Iron