title: Modifying effects of maternal Hb concentration on infant birth weight in women receiving prenatal iron-containing supplements: a randomised controlled trial.
abstract: Concerns have been raised about the benefits of Fe-containing supplements on infant birth weight among women with normal/high Hb levels at baseline. Thus far, no clinical trials have examined whether the effects of prenatal Fe-containing supplements on birth weight vary by maternal Hb levels. We compared the effects of Fe-folic acid (IFA) or multiple micronutrients (MMN) with folic acid (FA) supplements on birth weight among pregnant women with mild/no anaemia or high Hb levels. A double-blind randomised controlled trial was conducted in 2006-2009. In total, 18 775 pregnant women with mild/no anaemia (145 g/l) baseline Hb levels, IFA and MMN supplements increased birth weight by 91·44 (95% CI 3·37, 179·51) g and 107·63 (95% CI 21·98, 193·28) g (P<0·05), respectively, compared with the FA group. No differences were found between the IFA and the MMN group, regardless of maternal Hb concentration. In conclusion, the effects of Fe-containing supplements on birth weight depended on baseline Hb concentrations. The Fe-containing supplements improved birth weight in women with very high Hb levels before 20 weeks of gestation.
authors.affiliation: 1Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health,Peking University Health Science Center,Beijing 100191,People's Republic of China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Wang
authors.affiliation: 2Division of Nutrition,Physical Activity and Obesity,National Center for Chronic Disease Prevention and Health Promotion,Centers for Disease Control and Prevention (CDC),Atlanta,GA 30329-4027,USA.
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Mei
authors.affiliation: 1Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health,Peking University Health Science Center,Beijing 100191,People's Republic of China.
authors.forename: Hongtian
authors.initials: H
authors.lastname: Li
authors.affiliation: 1Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health,Peking University Health Science Center,Beijing 100191,People's Republic of China.
authors.forename: Yali
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: 1Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health,Peking University Health Science Center,Beijing 100191,People's Republic of China.
authors.forename: Jianmeng
authors.initials: J
authors.lastname: Liu
authors.affiliation: 2Division of Nutrition,Physical Activity and Obesity,National Center for Chronic Disease Prevention and Health Promotion,Centers for Disease Control and Prevention (CDC),Atlanta,GA 30329-4027,USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Serdula
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D001724:Birth Weight; D002681:China / Q000453:epidemiology; D019587:Dietary Supplements / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019266:Iron, Dietary / Q000009:adverse effects / Q000627:therapeutic use*; D039382:Maternal Nutritional Physiological Phenomena; D009752:Nutritional Status; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D011262:Pregnancy Trimester, Second; D012306:Risk; D012423:Rural Health; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D005296:Ferrous Compounds; D006397:Hematinics; D006454:Hemoglobins; D019266:Iron, Dietary; C031621:ferrous fumarate
keywords: Birth weight; FA folic acid; High maternal Hb; IFA Fe–folic acid; Iron-containing supplements; LBW low birth weight; MMN multiple micronutrients; RCT randomised controlled trial
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