title: Increased birth weight associated with regular pre-pregnancy deworming and weekly iron-folic acid supplementation for Vietnamese women.
abstract: BACKGROUND
  Hookworm infections are significant public health issues in South-East Asia. In women of reproductive age, chronic hookworm infections cause iron deficiency anaemia, which, upon pregnancy, can lead to intrauterine growth restriction and low birth weight. Low birth weight is an important risk factor for neonatal and infant mortality and morbidity.
  
  
  METHODS
  We investigated the association between neonatal birth weight and a 4-monthly deworming and weekly iron-folic acid supplementation program given to women of reproductive age in north-west Vietnam. The program was made available to all women of reproductive age (estimated 51,623) in two districts in Yen Bai Province for 20 months prior to commencement of birth weight data collection. Data were obtained for births at the district hospitals of the two intervention districts as well as from two control districts where women did not have access to the intervention, but had similar maternal and child health indicators and socio-economic backgrounds. The primary outcome was low birth weight.
  
  
  RESULTS
  The birth weights of 463 infants born in district hospitals in the intervention (168) and control districts (295) were recorded. Twenty-six months after the program was started, the prevalence of low birth weight was 3% in intervention districts compared to 7.4% in control districts (adjusted odds ratio 0.29, 95% confidence interval 0.10 to 0.81, p = 0.017). The mean birth weight was 124 g (CI 68 - 255 g, p<0.001) greater in the intervention districts compared to control districts.
  
  
  CONCLUSIONS
  The findings of this study suggest that providing women with regular deworming and weekly iron-folic acid supplements before pregnancy is associated with a reduced prevalence of low birth weight in rural Vietnam. The impact of this health system-integrated intervention on birth outcomes should be further evaluated through a more extensive randomised-controlled trial.
authors.affiliation: World Health Organization, Hanoi, Vietnam. PasseriniL@searo.who.int
authors.forename: Luca
authors.initials: L
authors.lastname: Passerini
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Casey
authors.forename: Beverley A
authors.initials: BA
authors.lastname: Biggs
authors.forename: Dai T
authors.initials: DT
authors.lastname: Cong
authors.forename: Luong B
authors.initials: LB
authors.lastname: Phu
authors.forename: Tran Q
authors.initials: TQ
authors.lastname: Phuc
authors.forename: Marco
authors.initials: M
authors.lastname: Carone
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000517:prevention & control; D000871:Anthelmintics / Q000008:administration & dosage*; D001724:Birth Weight; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006397:Hematinics / Q000008:administration & dosage*; D006725:Hookworm Infections / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D007501:Iron / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy* / Q000517:prevention & control; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy* / Q000517:prevention & control; D016896:Treatment Outcome; D014744:Vietnam; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D006397:Hematinics; D005492:Folic Acid; D007501:Iron