Effects of multimicronutrient supplementation during pregnancy on postnatal growth of children under 5 years of age: a meta-analysis of randomized controlled trials

• Published in: PloS one Vol. 9; no. 2; p. e88496
• Main Authors: Lu, Wei-Ping, Lu, Min-Shan, Li, Zong-Hua, Zhang, Cai-Xia
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20.02.2014; Public Library of Science (PLoS)
• Subjects: Age; Age Factors; Analysis; Anemia; Babies; Birth weight; Body Weights and Measures; Child development; Child Development - drug effects; Child Development - physiology; Child health; Child, Preschool; Children; Children & youth; Circumferences; Citation indexes; Clinical trials; Continuity (mathematics); Data bases; Epidemiology; Female; Growth; Head - anatomy & histology; Heat affected zone; Humans; Inspection; Iron; Lists; Maternal Nutritional Physiological Phenomena - drug effects; Maternal Nutritional Physiological Phenomena - physiology; Medical statistics; Medicine; Meta-analysis; Micronutrients; Micronutrients - pharmacology; National libraries; Nutrition research; Pregnancy; Pregnant women; Premature birth; Public health; Randomization; Randomized Controlled Trials as Topic; Reviews; Supplementation; Supplements; Trend analysis; Vitamin A; Vitamin deficiency; Womens health; Indonesia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0088496

The beneficial effect of antenatal multiple micronutrients supplementation on infant birth outcomes has been proposed by previous meta-analyses. However, their benefits on postnatal health of children have not been summarized. A meta-analysis of randomized controlled trials was conducted to evaluate the effect of maternal multimicronutrient supplementation on postnatal growth of children under 5 years of age. We searched both published and ongoing trials through the PubMed, EMBASE, CENTRAL (OVID platform), Web of Science, BIOSIS Previews, Chinese Science Citation Database, Scopus, ProQuest, ClinicalTrials.gov, Chinese Biomedical Database, and WANFANG database for randomized controlled trials. Reference lists of included studies and relevant reviews were also reviewed for eligible studies. Standard mean difference (SMD) was employed as the index for continuous variables by using fixed effects models. Trend analysis by visual inspection was applied to evaluate the change of mean difference of weight and height between the groups over time. Nine trials (12 titles) from nine different countries were retrieved for analysis. Pooled results showed that antenatal multimicronutrient supplementation increased child head circumference (SMD = 0.08, 95% CI: 0.00-0.15) compared with supplementation with two micronutrient or less. No evidence was found for the benefits of antenatal multimicronutrient supplementation on weight (P = 0.11), height (P = 0.66), weight-for-age z scores (WAZ) (P = 0.34), height-for-age z scores (HAZ) (P = 0.81) and weight-for-height z scores (WHZ) (P = 0.22). A positive effect was found on chest circumference based on two included studies. Antenatal multimicronutrient supplementation has a significant positive effect on head circumference of children under 5 years. No impact of the supplementation was found on weight, height, WAZ, HAZ and WHZ.