Abstract:Supplementation with multiple micronutrients (MM) during pregnancy may result in improved pregnancy and infant outcomes. We conducted meta-analyses of randomised controlled trials that evaluated the effects of prenatal supplementation with MM (defined as containing at least five micronutrients and typically included iron or iron and folic acid). The outcomes of interest were low birthweight (<2500 g), birthweight, small-for-gestational age (SGA), gestational age, preterm birth (<37 weeks' gestation), stillbirt… Show more
“…Birth outcomes have been assessed in another paper in this supplement. 33 Continuous data were pooled to get a standard mean difference. Dichotomous data were pooled to get a relative risk, which was reported along with 95% CI.…”
Section: Data Analysesmentioning
confidence: 99%
“…27 Some MMN supplementation studies have also suggested benefits on infant 28 and newborn mortality 29 and growth in later infancy. 30 Others have cautioned against the use of these supplements on the basis of an increased risk of perinatal mortality observed in some settings [31][32][33] although this has been disputed given the overall variation in context. 18,26 In the current conundrum an evaluation of the potential benefits and risks of replacing iron folate supplements with MMN is necessary and must in the first instance be based on a factual evaluation of the scientific benefits and risks.…”
Anaemia is one of the most resilient global public health problems and affects a staggering 1.62 billion of the world's population, largely concentrated in Asia and Africa. Anaemia contributes to almost 120 000 maternal deaths globally and indirectly to almost a fifth (18%) of the burden of maternal mortality. Given the widespread prevalence of micronutrient deficiencies in developing countries, supplementation with multiple micronutrients rather than iron folate alone, could be of potential benefit to the mother and the fetus. This review evaluates the evidence of the impact of multiple micronutrient supplements during pregnancy, in comparison with standard iron folate supplements, on maternal anaemia. A systematic review of randomised controlled trials was conducted using search engines like PubMed, the Cochrane Library and World Health Organization Regional Databases. Primary outcomes were 'maternal anaemia' and 'haemoglobin level'. We included seven studies for detailed data abstraction. There was no differential benefit of multiple micronutrients as compared with iron folate on maternal anaemia in the third trimester (relative risk = 1.03 [95% confidence interval 0.94, 1.12]). Results were similar for haemoglobin levels. In summary, multiple micronutrients have a similar effect on maternal anaemia compared with iron folate supplementation. These findings have to be interpreted in the context of other benefits of multiple micronutrient supplementation such as promoting better fetal growth and the possible increased risk of neonatal and perinatal mortality that are best resolved through large-scale effectiveness trials.
Keywords: multiple micronutrients, pregnancy, anaemia, haemoglobin.Anaemia is one of the most intractable global public health problems and affects a staggering 1.62 billion of the world's population, largely concentrated in Asia and Africa.1 Anaemia contributes to almost 120 000 maternal deaths globally and indirectly to almost a fifth (18%) of the burden of maternal mortality.2 In addition to maternal deaths, there are several adverse health outcomes associated with anaemia including maternal morbidity, stillbirths and neonatal mortality, low birthweight (LBW) and poor cognitive development in the offspring. 3 In terms of risks, women of reproductive age are more vulnerable to anaemia because of recurrent menstrual loss and the demands of pregnancy and repeated childbearing but corresponding estimates from adolescents and young women are lacking. The most recent global estimates suggest that the prevalence of anaemia is 41.8% among pregnant women and 30.2% among nonpregnant women. [1][2][3][4] Anaemia, as defined by low haemoglobin or haematocrit, is commonly used to assess the severity of iron deficiency in populations without high rates of malaria. The aetiology of anaemia is multi-factorial including genetic factors, dietary deficiencies, repeated pregnancies and high burden of infectious diseases.5 A multi-pronged approach is needed for its prevention and treatment. Although iron...
“…Birth outcomes have been assessed in another paper in this supplement. 33 Continuous data were pooled to get a standard mean difference. Dichotomous data were pooled to get a relative risk, which was reported along with 95% CI.…”
Section: Data Analysesmentioning
confidence: 99%
“…27 Some MMN supplementation studies have also suggested benefits on infant 28 and newborn mortality 29 and growth in later infancy. 30 Others have cautioned against the use of these supplements on the basis of an increased risk of perinatal mortality observed in some settings [31][32][33] although this has been disputed given the overall variation in context. 18,26 In the current conundrum an evaluation of the potential benefits and risks of replacing iron folate supplements with MMN is necessary and must in the first instance be based on a factual evaluation of the scientific benefits and risks.…”
Anaemia is one of the most resilient global public health problems and affects a staggering 1.62 billion of the world's population, largely concentrated in Asia and Africa. Anaemia contributes to almost 120 000 maternal deaths globally and indirectly to almost a fifth (18%) of the burden of maternal mortality. Given the widespread prevalence of micronutrient deficiencies in developing countries, supplementation with multiple micronutrients rather than iron folate alone, could be of potential benefit to the mother and the fetus. This review evaluates the evidence of the impact of multiple micronutrient supplements during pregnancy, in comparison with standard iron folate supplements, on maternal anaemia. A systematic review of randomised controlled trials was conducted using search engines like PubMed, the Cochrane Library and World Health Organization Regional Databases. Primary outcomes were 'maternal anaemia' and 'haemoglobin level'. We included seven studies for detailed data abstraction. There was no differential benefit of multiple micronutrients as compared with iron folate on maternal anaemia in the third trimester (relative risk = 1.03 [95% confidence interval 0.94, 1.12]). Results were similar for haemoglobin levels. In summary, multiple micronutrients have a similar effect on maternal anaemia compared with iron folate supplementation. These findings have to be interpreted in the context of other benefits of multiple micronutrient supplementation such as promoting better fetal growth and the possible increased risk of neonatal and perinatal mortality that are best resolved through large-scale effectiveness trials.
Keywords: multiple micronutrients, pregnancy, anaemia, haemoglobin.Anaemia is one of the most intractable global public health problems and affects a staggering 1.62 billion of the world's population, largely concentrated in Asia and Africa.1 Anaemia contributes to almost 120 000 maternal deaths globally and indirectly to almost a fifth (18%) of the burden of maternal mortality.2 In addition to maternal deaths, there are several adverse health outcomes associated with anaemia including maternal morbidity, stillbirths and neonatal mortality, low birthweight (LBW) and poor cognitive development in the offspring. 3 In terms of risks, women of reproductive age are more vulnerable to anaemia because of recurrent menstrual loss and the demands of pregnancy and repeated childbearing but corresponding estimates from adolescents and young women are lacking. The most recent global estimates suggest that the prevalence of anaemia is 41.8% among pregnant women and 30.2% among nonpregnant women. [1][2][3][4] Anaemia, as defined by low haemoglobin or haematocrit, is commonly used to assess the severity of iron deficiency in populations without high rates of malaria. The aetiology of anaemia is multi-factorial including genetic factors, dietary deficiencies, repeated pregnancies and high burden of infectious diseases.5 A multi-pronged approach is needed for its prevention and treatment. Although iron...
“…Особенно неблагоприятны дефициты микро-нутриентов для беременных женщин, поскольку отсутствие или недостаток микронутриентов имеют программирующее воздействие на здоровье ребёнка и будущего поколения [9]. Ещё в 1932 г. Ф. Хэйл опу-бликовал исследования по дефицитному по витамину А рациону питания свиней на ранних сроках зачатия.…”
CORRECTION OF MICRONUTRIENT STATUS OF THE IRKUTSK REGION POPULATION AS A MEANS OF LOWERING INFANT MORTALITY p = 0.004) (R = -0.99; p = 0.07), early neonatal (R = -0.99; p = 0.05), neonatal (R = -0.98; p = 0.06) and post-neonatal (R = -0.99; p = 0.002) infant mortality.
“…Folic acid has long been acknowledged as influential nutrient pre and during pregnancy to prevent neural tube defect 7,11 . Inadequate intrauterine nutrient supply brings information of adverse life conditions in the extra-uterine environment; it may enable to re-program metabolic pathways of the growing conceptus to prepare it to the shortage of food in later life.…”
ABSTRAKLatar Belakang: gizi yang baik bagi ibu sejak masa pra konsepsi dan konsepsi merupakan persiapan yang penting untuk kesehatan janin dan anak dimasa dating. Tujuan: tujuan dalam penulisan literature review ini adalah untuk menjelaskan secara argumentative bagaimana gizi sejak masa konsepsi dapat mempengaruhi kesehatan biologis anak. Pembahasan: hasil literature review menunjukkan bukti bahwa gizi sejak masa konsepsi dapat mempengaruhi kesehatan biologis anak. Beberapa artikel menunjukkan mekanisme yang menjelaskan kemungkinan mekanisme pengaruh gizi saat konsepsi terhadap kesehatan biologis anak dimasa datang seperti halnya Barker Hyphothesis atau fetal programming. Namun begitu, data yang diperoleh hingga saat ini masih belum meyakinkan sepenuhnya. Untuk itu perlu dikembangkan penelitian yang panjang atau longitudinal dan eksperimental yang dapat menggaransi kebenaran teori tersebut. Kesimpulan: argumentasi bahwa gizi sejak masa konsepsi diyakini berpengaruh terhadap kesehatan biologis anak dimasa depan semakin menguat dalam literature terkini walaupun bukti hasil penelitian eksperimental masih perlu banyak diakumulasikan untuk memastikan kebenarannya.
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