Micronutrient supplementation in pregnancy in developing countries

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1942 (Published 07 November 2008) Cite this as: BMJ 2008;337:a1942
  1. Girish Hiremath, research fellow
  1. 1Johns Hopkins University, Baltimore, MD 21287, USA
  1. ghirema1{at}jhmi.edu

    May have additional benefits to supplementation with iron plus folic acid

    Maternal undernutrition before and during pregnancy is linked to poor pregnancy outcomes. Maternal micronutritional deficiency can jeopardise the intrauterine growth or development of the fetus and increase perinatal morbidity and mortality by disrupting protein metabolism, gene transcription, endocrine functions, and transport of nutrients.1

    About 20% and 50% of women in south Asia and sub-Saharan Africa, respectively, have low body mass index (<18.5), a known risk factor for poor pregnancy outcomes.2 During pregnancy, 50-70% of women in developing countries have anaemia and night blindness, a sign of vitamin A deficiency.3 In the linked randomised controlled trial (doi:10.1136/bmj.a2001), Zeng and colleagues compare the effect of antenatal supplementation with multiple micronutrients, iron and folic acid, or folic acid alone on birth weight, duration of gestation, and maternal haemoglobin in the third trimester.4

    Politics, social class, social milieu, cultural practices, access to …

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