Vitamin and mineral supplementation during pregnancy in low- and middle-income countries
Citation: Oh C, Keats EC, Bhutta ZA. Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients. 2020;12(2):491.
Language: English.
Free to view: Yes.
What is this? Many women and children in low- and middle-income countries (LMICs) are deficient in many key micronutrients. During pregnancy, deficiencies often worsen due to increased energy and nutritional demands.
In this systematic review, the authors searched for studies of the effects of supplementation interventions on maternal, birth, child health and developmental outcomes. They restricted their searches to articles published in English between 1995 and 31 October 2019. They included 72 randomized trials and quasi-experimental studies. Two trials were multi-region studies. The remainder were from East Asia and Pacific (12 studies), Middle East and North Africa (13), sub-Saharan Africa (18), South Asia (19), Latin America and the Caribbean (7) and Europe and Central Asia (1).
What was found:
Multiple micronutrient supplementation improved several key birth outcomes, such as preterm birth, small-for-gestational age and low birthweight; and child outcomes, including diarrhea incidence and retinol concentration.
Micronutrient supplementation had little to no effect on maternal, neonatal, perinatal or infant mortality.
Iron-folic acid supplementation improved maternal anemia and reduced low birthweight.
For single micronutrient supplementation, improvements were seen in pre-eclampsia/eclampsia (calcium), maternal anemia (iron), preterm births (vitamin D) and maternal serum zinc concentration (zinc).
Lipid-based nutrient supplementation had no apparent effect on outcomes.