Table 1 Description of trials with follow-up reports
Location | Trial | Randomisation scheme | Pregnant women allocated (MMN and Fe60 Fol groups only) | Mean duration from LMP to beginning of supplementation and when supplementation stoppeda | Control content | Intervention contentb | Mean maternal BMI (kg/m2) | Main results from original trial paper (intervention effect relative to comparison group) |
|---|---|---|---|---|---|---|---|---|
Bangladesh JiVitA | West et al. [26] | Cluster | 127,282 women under pregnancy surveillance; 44,567 pregnancies recruited in 596 clusters | Median at enrolment 9 weeks until 12 weeks after birth | Iron 27 mg, folic acid 600 μg | Vit A, thiamine, riboflavin, vit B3, vit B6, folic acid, B12, vit C, vit D, vit E, copper, iodine, iron, selenium, zinc | Mean BMI unknown; proportion < 18.5 40 % | Birthweight, + 54 g (95 % CI, 41–66 g) SGA RR, 0.98 (95 % CI, 0.96–1.01) Gestation, 0.30 weeks (95 % CI, 0.21–0.40 weeks) Neonatal mortality RR, 0.98 (95 % CI, 0.88–1.20) |
Bangladesh MINIMat | Persson et al. [27] | Individual | 1478 | 102 days until birth | Iron 60 mg, folic acid 400 μg and “usual” food supplementation | UNIMMAP and “usual” food supplementation | 20.3 | Birthweight in MMN, 2710 g (95 % CI, 2675–2745 g) Birthweight in control, 2665 g (95 % CI, 2631–2699 g) Gestation in MMN, 39.1 weeks (95 % CI, 38.9–39.3 weeks); gestation in control, 38.8 weeks (95 % CI, 38.6–39.0 weeks) Perinatal mortality RR, 0.95 (95 % CI, 0.59–1.5) Neonatal mortality RR, 1.1 (95 % CI, 0.64–2.0) |
Burkina Faso | Roberfroid et al. [23] | Individual | 1428 | 125 days until 3 months after birth | Iron 60 mg, folic acid 400 μg | UNIMMAP; also randomly assigned to receive either chloroquine 300 mg weekly or sulfadoxine 1500 mg and pyrimethamine 75 mg once in 2nd and 3rd trimesters as malaria chemoprophylaxis | 20.9 | Birthweight, + 41 g (95 % CI, –11 to 94 g), adjusted for malaria prevention and health centre SGA, 0.83 (95 % CI, 0.65–1.07), adjusted for malaria prevention and health centre Gestation, –0.04 weeks (95 % CI, –0.38 to 0.29 weeks), adjusted for malaria prevention and health centre Perinatal mortality OR, 1.78 (95 % CI, 0.95–3.32) Neonatal mortality OR, 2.1 (95 % CI, 0.78–5.64) |
China | Zeng et al. [28] | Cluster | 3811 women in 104 clusters | 96 days until birth | Iron 60 mg, folic acid 400 μg | UNIMMAP | 20.9 | Birthweight in MMN, 3198 g; birthweight in control, 3174 g SGA in MMN, 16.9 %; SGA in control, 18.9 % Gestation in MMN, 39.8 weeks; gestation in control, 39.8 weeks PMR in MMN group, 50.9; PMR in control group, 36.9 NMR in MMN group, 12.4; NMR in control group, 10.7 |
Guinea Bissau | Kaestel et al. [24] | Individual | 1403 | 158 days until birth | Iron 60 mg, folic acid 400 μg | UNIMMAP; if haemoglobin concentration < 70 g/L, given additional iron 60 mg daily; all women received insecticide-treated bednets, weekly antimalarial prophylaxis and malaria treatment if needed | 23.3 | Birthweight, + 53.0 g (95 % CI, –19 to 125 g) Perinatal mortality OR, 0.82 (95 % CI, 0.53–1.26) Neonatal mortality OR, 1.18 (95 % CI, 0.66–2.11) |
Indonesia | Shankar et al. [29] | Cluster | 31,290 women, 262 randomly assigned midwives | 146 days until 90 days after birth | Iron 30 mg, folic acid 400 μg | UNIMMAP | Not recorded | Birthweight, + 21 g (95 % CI, –11 to 53 g) Perinatal mortality RR, 0.90 (95 % CI, 0.79–1.03) Neonatal mortality RR, 0.90 (95 % CI, 0.76–1.06) |
Mexico | Ramakrishnan et al. [25] | Individual | 873 children born in the trial were subsequently randomised to receive postnatal multiple micronutrients or iron and vitamin A supplements | 69 days until birth | Iron 60 mg; no supplements on Sundays | Vit A, thiamine, riboflavin, niacin, vit B6, folic acid, vit B12, vit C, vit D3, vit E, iron, magnesium, zinc; no supplements taken on Sundays | 24.1 | Birthweight in MMN, 2981 g; birthweight in control, 2977 g SGA in MMN, 10.1 %; SGA in control, 11.8 % Gestation in MMN, 39.5 weeks; gestation in control, 39.6 weeks |
Nepal Janakpur | Osrin et al. [30] | Individual | 1200 | 112 days until birth | Iron 60 mg, folic acid 400 μg | UNIMMAP; if haemoglobin concentration < 70 g/L, given extra iron 60 mg daily and anthelminthic treatment; if symptoms of night-blindness, vitamin A 2000 μg | 19.9 | Birthweight, + 77 g (95 % CI, 24–130 g) Gestation, 0.2 weeks (95 % CI, –0.1 to 0.4 weeks) PMR in MMN, 49.0; PMR in control, 40.5 NMR in MMN, 30.6; NMR in control, 20.0 |
Nepal Sarlahi | Christian et al. [34] Christian et al. [31] | Cluster | 14,036 women under pregnancy surveillance; 2007 pregnancies recruited in 169 clusters | 80 days until 12 weeks after birth | Iron 60 mg, folic acid 400 μg, Vit A 1000 μg | Vit A, thiamine, riboflavin, vit B3, vit B6, folic acid, vit B12, vit C, vit D, vit E, vit K, copper, iron as ferrous fumerate, magnesium and zinc; albendazole was offered in 2nd and 3rd trimesters | 19.3 | Birthweight in MMN, 2659 g; birthweight in control, 2652 g SGA in MMN, 53.8 %; SGA in control, 51.7 % PMR in MMN group, 87.1; PMR in control group, 62.4 NMR in MMN group, 54.0; NMR in control group, 36.3 |