Impact of micronutrient supplementation during pregnancy on birth weight, duration of gestation, and perinatal mortality in rural western China: double blind cluster randomised controlled trial

• Published in: BMJ 2008-11, Vol.337 (7680), p.1211-1215
• Main Authors: Zeng, Lingxia, Cheng, Yue, Dang, Shaonong, Yan, Hong, Dibley, Michael J, Chang, Suying, Kong, Lingzhi
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Birth Weight; Births; China; Clinical trials; Cluster Analysis; Developing countries; Dietary Supplements; Diseases of mother, fetus and pregnancy; Double-Blind Method; Epidemiology; Female; General aspects; Gestation period; Gestational Age; Gynecology. Andrology. Obstetrics; Hemoglobins - metabolism; Humans; Infant mortality; Infants; Iron; LDCs; Low birth weight; Medical sciences; Micronutrients; Micronutrients - administration & dosage; Mortality; Neonatal care; Neonatal mortality; Newborn babies; Nutrition Disorders - therapy; Patient Compliance; Perinatal Mortality; Pregnancy; Pregnancy Complications - therapy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Pregnant women; Prenatal care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rural Health; Supplements; Vitamin B; Womens health
• ISSN: 0959-8138; 0959-8146; 0959-535X; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.a2001

Objective To examine the impact of antenatal supplementation with multiple micronutrients or iron and folic acid compared with folic acid alone on birth weight, duration of gestation, and maternal haemoglobin concentration in the third trimester.Design Cluster randomised double blind controlled trial.Setting Two rural counties in north west China.Participants 5828 pregnant women and 4697 live births.Interventions Villages were randomised for all pregnant women to take either daily folic acid (control), iron with folic acid, or multiple micronutrients with a recommended allowance of 15 vitamins and minerals.Main outcome measures Birth weight, length, and head circumference measured within 72 hours after delivery. Neonatal survival assessed at the six week follow-up visit.Results Birth weight was 42 g (95% confidence interval 7 to 78 g) higher in the multiple micronutrients group compared with the folic acid group. Duration of gestation was 0.23 weeks (0.10 to 0.36 weeks) longer in the iron-folic acid group and 0.19 weeks (0.06 to 0.32 weeks) longer in the multiple micronutrients group. Iron-folic acid was associated with a significantly reduced risk of early preterm delivery (