Pregnancy supplements questioned

Pregnant women may boost their babies’ health more by taking multiple micronutrient supplementation (MMN) than iron and folic acid, research suggests.

Indonesian scientists found that MMN is more effective than iron and folic acid (IFA) supplements alone at preventing early infant death and foetal loss.

Previous studies have linked to MMN to improvements in birth weight, gestational length and other factors but others have shown no advantages.

For the latest study, published today in the Lancet journal, scientists at the University of Mataram studied 31,290 pregnant women in Indonesia.

One group (15,486 women) received IFA while the other (15,804) was given MMN.

The IFA group had 30mg iron and 400microgram folic acid and the MMN group had the same doses plus vitamins A, C, D, E B1, B2, B6, B12, niacin, zinc, copper, selenium and iodine.

Supplements were taken from enrolment in the study to 90 days after giving birth.

Children of women taking MMN had an 18 per cent reduction in early infant mortality (deaths in the first 90 days after birth) compared to those given IFA.

The positive effect was most pronounced in mothers who were undernourished or anaemic, with reductions in early infant mortality of 25 per cent and 38 per cent respectively.

Reductions in combined foetal loss and early infant mortality were also greater for women given MMN compared with IFA.

Risk of lower birthweight was also reduced.

“Our study suggests that maternal MMN supplementation, compared with IFA, reduced early infant mortality,” the researchers conclude.

“This effect was seen predominantly after the first five days of life, and was most pronounced from days 29 to 90 after birth. Effects were greater in women consuming larger numbers of supplements and in those who were anaemic or undernourished at enrolment.”

In an accompanying comment in the Lancet, Professor Zulfiqar Bhutta and Dr Batool Haider from Pakistan’s Aga Khan University said the findings provide a strong argument for larger effectiveness trials of maternal multiple micronutrient supplementation.

“In view of the controversy surrounding these supplements and birth outcomes, these trials must be done in programmatic settings with strong monitoring and evaluation components,” they said.