Taking a daily multivitamin can help pregnant women in developing nations prevent pre-term births, increase their babies’ birth weights, and deliver infants who are healthier overall, a study in Bangladesh suggests.
In the large randomized trial, a supplement with 15 essential micronutrients was superior to the current standard in many developing countries—daily supplements containing only iron and folic acid.
“Our study shows that women in undernourished societies should be given a multiple micronutrient supplement during pregnancy,” says study leader Keith P. West Jr., professor of infant and child nutrition at Johns Hopkins University.
“It increases birth size because the babies stay in the womb longer, and when that happens they are born a little larger and better equipped to handle life outside the womb. There is clear evidence of benefit.”
Inadequate diets are a serious public health problem in many parts of the world where many pregnant women lack micronutrients critical to the growth and development of their fetuses. That sets these children back even before their lives outside the womb have begun.
For the JiVitA Project, reported in the Journal of the American Medical Association, researchers recruited roughly 45,000 pregnant women in rural Bangladesh beginning in December 2007 and assigned them to receive either a daily multivitamin or an iron-folic acid supplement.
The women were followed through their pregnancies and, for those who gave birth, at one, three, and six months after their children were born. There were roughly 14,000 live births in each group in the trial, with other pregnancies lost to miscarriage, abortion, or stillbirth.
Women who received the larger number of micronutrients were 15 percent less likely to give birth prematurely, prior to 37 weeks of gestation. Pre-term birth is a leading cause of infant mortality in many parts of the world.
Babies in the multivitamin group were also 12 percent less likely to record a low birth weight (under 2.5 kilograms or 5 pounds, 8 ounces) and 11 percent less likely to be stillborn. On average, infants born to mothers in the multivitamin group were born two to three days later than those in the iron-folic acid group, giving them more time to bulk up before birth, and were an average of 55 grams (or roughly 2 ounces) heavier.
More costly vitamins
While infant mortality rates at 6 months of age were roughly the same in each group, the research suggests that girls born to mothers receiving the vitamin and mineral preparation may have survived better than girls whose mothers received only iron and folic acid. This did not happen in boys, which requires further data analysis to fully understand why.
“In countries like the United States, where there is already better vitamin and mineral nutrition, women often start taking micronutrient supplements as soon as they become pregnant, if not before,” says West, director of the Johns Hopkins Center for Human Nutrition.
“But they don’t in the developing world. Vitamin and mineral supplements are more costly—probably several cents per tablet more—so in cultures where families make only a few dollars a day we need to be able to show that the investment is worthwhile in terms of having an impact on the health of mothers and their children. This study provides the needed evidence.”
The Bill and Melinda Gates Foundation provided funding for the JiVitA-3 Trial, which also received support from Sight and Life Global Nutrition Research Institute. DSM and Beximco Pharmaceuticals provided supplements.
Source: Johns Hopkins University