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Cited by 24Child Nutrition and Water AccessGlobal Maternal and Child HealthPublic Health and Nutrition

Maternal mineral and vitamin supplementation in pregnancy

Open access
Yakoob, Mohammad Yawar, Khan, Yasir Pervez, Bhutta, Zulfiqar Ahmed·2010·Expert Review of Obstetrics & Gynecology
DOI 10.1586/eog.10.8
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Abstract

Deficiency of vitamins and minerals, collectively known as micronutrients, during pregnancy can have important adverse effects on maternal and birth outcomes. Evidence-based nutrition interventions can make a difference and potentially avert these outcomes. Iron supplementation has been shown to improve maternal mean hemoglobin concentration at term and reduce the risk of anemia. Zinc supplementation has been shown to result in a small but significant reduction in preterm births. A cluster-randomized study in Nepal showed a 40% reduction in maternal mortality up to 12 weeks postpartum with weekly vitamin A and 49% biweekly β-carotene supplementation but subsequent large studies in Bangladesh and Ghana have failed to demonstrate any impact on mortality. Maternal vitamin A supplementation has no role in preventing mother-to-child transmission of HIV in HIV-infected pregnant women. Periconceptional folic acid supplementation reduces the risk of neural tube defects, while supplementation with vitamin D reduces the incidence of neonatal hypocalcemia with no impact on craniotabes. Iodine supplementation during pregnancy has also been suggested to reduce the risk of perinatal and infant mortality, and the risk of endemic cretinism at 4 years of age. Calcium supplementation reduced the risk of preeclampsia in women with low baseline calcium dietary intake, while magnesium supplementation has been associated with a lower frequency of preterm births and adverse neurodevelopmental outcomes in childhood. Other vitamins and minerals, such as vitamins B, C and E, copper and selenium, have been associated with fetal development, but their impact on pregnancy outcomes is not clear. Given such widespread maternal vitamin and mineral deficiencies, it is logical to consider supplementation with multiple micronutrient preparations in pregnancy. The clinical benefits of such an approach over single-nutrient supplements are unclear, and this article explores the current concepts, evidence and limitations of maternal multiple-micronutrient supplementation.

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Crossref · 10.1586/eog.10.8

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99 of 99 references verified0 citation errors · 0 not checkable

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  • Adherence to IFAS during pregnancy is still low in Tanzania despite national guideline emphasis.

    “Despite the national guideline emphasis, adherence to iron-folic acid supplements during pregnancy is still low [4].”

    From Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania (2020) · cites this paper as [4]

    The Supplementation strategies section describes poor compliance with iron–folic acid supplementation during pregnancy. The Iron section notes recommendations by UN agencies, but the paper does not establish low adherence in Tanzania or describe an emphasis in Tanzanian national guidelines. No page numbers are available in our copy. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Tanzania requires all pregnant women to consume 30-60 mg of iron and 400 μg of folic acid daily starting early at first antenatal visit.

    “Tanzania adopted the WHO recommendation and requires all pregnant women to consume 30-60 mg of a dose of iron and 400 μg of folic acid daily starting early at first antenatal visit [2, 4, 13].”

    From Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania (2020) · cites this paper as [4]

    The Dosage & potential interactions section (page unavailable) recommends 60 mg iron and 400 µg folic acid daily for pregnant women, with 30 mg iron recommended where foods are iron-fortified. The review also recommends iron–folic acid supplementation for pregnant women in developing countries, but it does not say Tanzania adopted or requires this regimen, or specify starting it at the first antenatal visit. (LLM, conf=0.88)

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  • Low adherence to IFAS compromises the effectiveness of IFAS as a strategy to control anaemia during pregnancy.

    “IFAS is considered the best strategy to control anaemia during pregnancy, but low adherence to IFAS compromises the effectiveness of this strategy [4].”

    From Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania (2020) · cites this paper as [4]

  • The structured questionnaire was developed based on TDHS and published articles, translated to Swahili and back-translated, and pretested before data collection.

    “A structured questionnaire established based on information from Tanzania Demographic Health Survey (TDHS) and published articles was administered to women who had children aged 0-6 months [4, 16–18].”

    From Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania (2020) · cites this paper as [4]

    The cited paper’s Other vitamins & minerals section discusses supplementation studies, including a trial in Tanzania, but not the development or administration of a questionnaire. Searches for TDHS, Swahili translation, back-translation, pretesting, and women with children aged 0–6 months found no passage addressing the claim. (LLM, conf=0.76)

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  • The sample size was determined using a single population proportion formula with 95% CI, 5% margin error, 80% power, and 10% nonresponse, based on national adherence P=21%.

    “The sample size was determined based on a single population proportion formula (Z2P(1 − P)/(e)2) with a 95% Cl, 5% margin error (Zα/2 = 1.96) by considering the national adherence to IFAS (P = 21%) [4] at 80% desired power (Bα) and 10% of the estimated nonresponse rate.”

    From Adherence to Iron-Folic Acid Supplementation and Associated Factors among Pregnant Women in Kasulu Communities in North-Western Tanzania (2020) · cites this paper as [4]

    The citation is attached to the claimed national IFAS adherence estimate of 21%, not to the citing authors’ sample-size calculation. The cited paper’s Supplementation strategies section discusses poor compliance, but gives no national adherence estimate of 21% (searched: 21%, adherence, compliance). (LLM, conf=0.76)

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Cites

2 retracted

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Research works printed but not linked: 1

  1. [53]53. •• Comprehensive review of interventions of different micronutrients to reduce the burden of maternal and child undernutrition, including a series of systematic reviews on micronutrients such as iodine in the web appendices.

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Authors
Yakoob, M. Y., Khan, Y. P., & Bhutta, Z. A.
Affiliations
Aga Khan University (PK)
ORCID
Venue
Expert Review of Obstetrics & Gynecology
Publisher
Informa UK Limited
Published
2010-03
Volume
5
Issue
2
Pages
241-256
ISSN
  • 1747-4108 (ISSN-L)
  • 1747-4116
DOI
10.1586/eog.10.8
OpenAlex
W2123409633
Cited by
24
References
99
Citations by year
2023: 3 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 3 · 2018: 1 · 2014: 2 · 2013: 3 · 2012: 3
FWCI
2.13
Type
journal article
Language
en
Open access
Locations
Expert Review of Obstetrics & Gynecology (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
Keywords
maternal micronutrient supplementation, pregnancy, iron supplementation, zinc supplementation, vitamin A supplementation, beta-carotene, folic acid, vitamin D, iodine supplementation, calcium supplementation, magnesium supplementation, multiple micronutrient supplements, anemia in pregnancy, preterm birth, maternal mortality, neural tube defects, neonatal hypocalcemia, preeclampsia, maternal and child health

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