Antioxidants

[Guru]

Multivitamins during pregnancy may boost the birth weight of newborns

Supplementation with multivitamins during pregnancy may boost the birth weight of newborns, and should be considered for all expectant mothers in developing countries, says a major clinical trial.
"In light of these benefits and the low cost of the supplements, multivitamins should be considered for all pregnant women," wrote lead author Wafaie Fawzi in the New England Journal of Medicine.

The research is of particular importance since an estimated 20 million children worldwide are born with low birth weight, defined as less than 2,500 grams (5.5 pounds), with over 95 per cent these in developing countries.

Low birth weight has been linked to higher risks of negative health outcomes, including neonatal and infant mortality, poor growth and cognitive development, and higher risks of chronic diseases later in life, like diabetes and heart disease.

The new study, by researchers from the Harvard School of Public Health and Muhimbili University College of Health Sciences in Dar es Salaam, Tanzania, involved 8,468 HIV-negative pregnant women enrolled at 12 to 27 weeks gestation and randomly assigned to receive daily multivitamin or placebo supplements from the time of enrolment until six weeks after birth.

The supplements included vitamins B1 (20 mg), B2 (20 mg), B6 (25 mg), B12 (50micrograms), niacin (100 mg), vitamin C (500 mg), vitamin E (30 mg), and folic acid (0.8 mg).

The researchers report that at the end of the study daily multivitamin supplements during pregnancy significantly reduced the risks of low birth weight and a birth size that was small-for-gestational age by 18 and 23, respectively.. No significant effects were observed on the risks of prematurity or foetal death, however.

"Multivitamins, including B vitamins and antioxidant vitamins C and E, may lead to better birth outcomes in several ways. By enhancing maternal nutritional status and immunity during pregnancy, multivitamins may reduce the risk of intrauterine infections," wrote the researchers.

"Better birth outcomes may also occur by means of improvements in maternal haematologic status. Low haemoglobin levels are associated with increased risks of adverse pregnancy outcomes, including low birth weight."

The researchers pointed out that many developing countries already have in place a system for providing iron and folate supplements during pregnancy. These supplements are estimated cost of less than $1 per person for the duration of pregnancy and are produced in bulk by the United Nations Children's Fund (UNICEF).

"The increase in cost of incorporating the RDA of additional nutrients is conservatively estimated to be about 20 per cent, and scaling up prenatal multiple micronutrient supplementation could be a highly cost-effective approach to improving birth outcomes among pregnant women in developing countries," concluded the researchers.

Source: New England Journal of Medicine
5 April 5 2007, Volume 356, Issue 14, Pages 1423-1431
"Vitamins and Perinatal Outcomes Among HIV-Negative Women In Tanzania"Authors: W.W. Fawzi, G.I. Msamanga, W. Urassa, E. Hertzmark, P. Petraro, W.C. Willett, D. Spiegelman