Extra antenatal supplements do little for healthy Chinese womenBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f249 (Published 16 January 2013) Cite this as: BMJ 2013;346:f249
Pregnant women in rural China are prescribed folic acid supplements, but do they need iron and micronutrients too? In the largest trial so far, adding iron—with or without micronutrients—made little difference to pregnancy outcomes, including perinatal deaths, neonatal deaths, infant deaths, birth weight, and preterm births. Extra iron helped reduce the risk of anaemia in late pregnancy compared with folic acid alone, but the impact was small in absolute terms because these women started the trial with a mean haemoglobin concentration of 125 g/L. Women with even moderate anaemia were excluded. By the third trimester 7.7% of women taking folic acid alone had a haemoglobin concentration below 110 g/L, compared with 5.5% in the two other groups.
The results look secure and probably reflect the good general health of this population of educated farmers, say the researchers. They recruited 18 775 women from five rural counties in northern China. The women were well nourished and had access to good antenatal and obstetric care. All gave birth in local hospitals.
The new trial found no evidence of harm associated with micronutrient supplements or iron, but little evidence of the benefit reported in other populations, including pregnant women in the US and other parts of China. Whether women need these extra supplements seems to depend on where they live, what they eat, and how they are cared for, say the researchers.
Cite this as: BMJ 2013;346:f249