Maternal supplementation with multiple micronutrients rather than with just iron and folic acid can reduce early infant deaths, particularly in women who are undernourished or anaemic, new research shows.
The Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT) involved 31 290 pregnant women in Indonesia who, through their midwives, were randomised to receive multiple micronutrients (MMN) or just iron and folic acid (IFA) supplementation.
The IFA contained 30 milligrams iron and 400 micrograms folic acid. The MMN contained the exactly the same dose of iron and folic acid, plus vitamins A, C, D, E, B1, B2, B6, B12, niacin, zinc, copper, selenium, and iodine. The supplements were to be taken daily during pregnancy through 90 days after delivery.
Overall, infants of MMN-treated mothers were 18 percent less likely to die within 90 days of birth than were infants of IFA-treated mothers, Dr. Anuraj Shankar, from the University of Mataram in Indonesia, and colleagues report in Saturday's issue of The Lancet.
Specifically, infant mortality rates were 35,5 versus 43 deaths per 1 000 livebirths in the two groups, respectively.
For mothers who were undernourished or anaemic, the effect of MMN was even greater, with reductions in early infant mortality of 25 percent and 38 percent, respectively, compared with IFA supplementation.
MMN use was also associated with an 11 percent reduction in combined foetal loss and early infant death. For undernourished or anaemic women, the reductions were 15 percent and 29 percent, respectively.
MMN-treated mothers were 14 percent less likely than controls to have a low birthweight infant. Once again, the risk reduction seen with MMN use was even higher for anaemia mothers - 33 percent.
"We feel that the results of SUMMIT provide a strong basis to pursue larger effectiveness trials of maternal MMN supplements," Dr. Zulfiqar A. Butta and Dr. Batool Azra Haider, from Aga Khan University in Karachi, Pakistan, comment in a related editorial.