Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low‐ and middle‐income countries. Issue 1 (27th May 2019)

• Record Type: Journal Article
• Authors: Bourassa, Megan W.; Osendarp, Saskia J.M.; Adu‐Afarwuah, Seth; Ahmed, Saima; Ajello, Clayton; Bergeron, Gilles; Black, Robert; Christian, Parul; Cousens, Simon; de Pee, Saskia; Dewey, Kathryn G.; Arifeen, Shams El; Engle‐Stone, Reina; Fleet, Alison; Gernand, Alison D.; Hoddinott, John; Klemm, Rolf; Kraemer, Klaus; Kupka, Roland; McLean, Erin; Moore, Sophie E.; Neufeld, Lynnette M.; Persson, Lars‐Åke; Rasmussen, Kathleen M.; Shankar, Anuraj H.; Smith, Emily; Sudfeld, Christopher R.; Udomkesmalee, Emorn; Vosti, Stephen A.
• Is Part Of: Annals of the New York Academy of Sciences. Volume 1444:Issue 1(2019)
• Page Start: 6
• Page End: 21
• Publication Date: 2019-05-27
• Subjects: LMICs -- micronutrient -- supplements -- pregnancy; Medical sciences -- Periodicals; Medicine -- Periodicals; Science -- Periodicals; 610
• DOI: 10.1111/nyas.14121
• Languages: English
• ISSNs: 0077-8923

Abstract

Abstract: Inadequate micronutrient intakes are relatively common in low‐ and middle‐income countries (LMICs), especially among pregnant women, who have increased micronutrient requirements. This can lead to an increase in adverse pregnancy and birth outcomes. This review presents the conclusions of a task force that set out to assess the prevalence of inadequate micronutrient intakes and adverse birth outcomes in LMICs; the data from trials comparing multiple micronutrient supplements (MMS) that contain iron and folic acid (IFA) with IFA supplements alone; the risks of reaching the upper intake levels with MMS; and the cost‐effectiveness of MMS compared with IFA. Recent meta‐analyses demonstrate that MMS can reduce the risks of preterm birth, low birth weight, and small for gestational age in comparison with IFA alone. An individual‐participant data meta‐analysis also revealed even greater benefits for anemic and underweight women and female infants. Importantly, there was no increased risk of harm for the pregnant women or their infants with MMS. These data suggest that countries with inadequate micronutrient intakes should consider supplementing pregnant women with MMS as a cost‐effective method to reduce the risk of adverse birth outcomes. Abstract : This review presents the conclusions of a task force that set out to provide guidance to countries considering using multiple micronutrient supplements in pregnant women by assessing the available evidence.