June 14, 2009 Prenatal multivitamin supplements are associated with a significantly reduced risk of babies with a low birth weight compared with prenatal iron-folic acid supplementation, found a new study in the Canadian Medical Association Journal (CMAJ).
The World Health Organization currently recommends iron-folic acid supplements for all pregnant women. Previous studies have not shown an advantage from prenatal multimicronutrient supplementation over iron-folic acid supplementation.
"Low birth weight and related complications are considered the most common cause of global infant mortality under the age of 5 years," write Dr. Prakash Shah and study coauthors from Mount Sinai Hospital in Toronto. "With the possibility of reducing low birth weight rates by 17%, micronutrients supplementation to pregnant women, we believe, offers the highest possible return for the investment. These results are synthesized findings from 15 studies published worldwide."
It is estimated that of the total 133 million births worldwide per year, 15.5% are low birth weight babies. The authors suggest that approximately 1.5 million babies born with a low birth weight could be avoided each year globally, if all mothers receive prenatal multimicronutrient supplementation.
The research is limited by variability among the included studies, including timing, duration, composition of micronutrients, and characteristics of the study populations.
In a related commentary, Dr. Zulfiqar Bhutta and Dr. Batool Azra Haider of the Aga Khan University in Karachi, Pakistan recommend that multimicronutrient supplementation during pregnancy replace iron and folate supplements in susceptible populations if it is proven safe and effective. They note that multiple interventions in developing countries may be necessary to improve maternal nutrition and fetal status such as fortified food supplements, interventions that address specific nutrient deficiencies, and measures to reduce the burden of HIV, malaria and other diseases.
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- Prakesh S. Shah, MD MSc, Arne Ohlsson, MD MSc on behalf of the Knowledge Synthesis Group on Determinants of Low Birth Weight and Preterm Births. Effects of prenatal multimicronutrient supplementation on pregnancy outcomes: a meta-analysis. Canadian Medical Association Journal, [link]
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