title: Iron-Folic Acid Supplementation During Pregnancy Reduces the Risk of Stunting in Children Less Than 2 Years of Age: A Retrospective Cohort Study from Nepal.
abstract: The aim of the study was to investigate the effect of antenatal iron-folic acid (IFA) supplementation on child stunting in Nepalese children age <2 years. A retrospective cohort study design was used, in which a pooled cohort of 5235 most recent live births 2 years prior to interview from three Nepal Demographic and Health Surveys (2001, 2006 and 2011) was analysed. The primary outcome was stunting in children age <2 years. The main exposure variable was antenatal IFA supplementation. Multivariate Poisson regression analysis was performed. In our sample, 31% and 10% of Nepalese children age <2 years were stunted and severely stunted, respectively. The adjusted relative risk of being stunted was 14% lower in children whose mothers used IFA supplements compared to those whose mothers did not use (aRR = 0.86, 95% CI = 0.77-0.97). Additionally, the adjusted relative risk of being stunted was significantly reduced by 23% when antenatal IFA supplementation was started ≤6 months with ≥90 IFA supplements used during pregnancy (aRR = 0.77, 95% CI = 0.64-0.92). Antenatal IFA supplementation significantly reduced the risk of stunting in Nepalese children age <2 years. The greatest impact on the risk reduction of child stunting was when IFA supplements were started ≤6 months with ≥90 supplements were used.
authors.affiliation: United Nations Office for Project Services (UNOPS), Diplomatic Enclave, Islamabad 44000, Pakistan. drbin01@hotmail.com.
authors.forename: Yasir Bin
authors.initials: YB
authors.lastname: Nisar
authors.affiliation: Sydney School of Public Health, The University of Sydney, Sydney 2006, Australia. michael.dibley@sydney.edu.au.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dibley
authors.affiliation: United Nations Children's Fund (UNICEF), Regional Office for South Asia, Kathmandu 5815, Nepal. vaguayo@unicef.org.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Aguayo
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000494:pharmacology / Q000627:therapeutic use*; D006130:Growth Disorders / Q000517:prevention & control*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007501:Iron / Q000494:pharmacology / Q000627:therapeutic use*; D019266:Iron, Dietary / Q000494:pharmacology / Q000627:therapeutic use*; D018977:Micronutrients / Q000494:pharmacology / Q000627:therapeutic use*; D009390:Nepal; D011247:Pregnancy; D011295:Prenatal Care; D039401:Prenatal Nutritional Physiological Phenomena; D012189:Retrospective Studies
chemical_list: D019266:Iron, Dietary; D018977:Micronutrients; D005492:Folic Acid; D007501:Iron
keywords: IFA supplementation; Stunting; child; risk
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