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Effects of prenatal micronutrient supplementation on complications of labor and delivery and puerperal morbidity in rural Nepal
Author(s) -
Christian Parul,
Khatry Subarna K.,
LeClerq Steven C.,
Dali Sanu Maiya
Publication year - 2009
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2009.03.040
Subject(s) - medicine , micronutrient , pregnancy , relative risk , obstetrics , prenatal care , confidence interval , folic acid , pediatrics , population , environmental health , genetics , pathology , biology
Objective To examine the effect of supplemental prenatal folic acid, folic acid–iron, folic acid–iron–zinc, and multiple micronutrients on maternal morbidity in rural Nepal. Methods A cluster‐randomized double‐masked controlled trial of pregnant women who received daily supplements from early pregnancy through 3 months post partum as per the treatment allocation. Women were interviewed at birth about labor and delivery complications and for 9 days post partum to obtain 24‐hour histories of morbidity. Results A total of 3986 (97.3%) women completed an interview regarding labor and delivery; morbidity history was available for 3564 (87.0%) women. Folic acid–iron reduced the risk of postpartum hemorrhage (relative risk [RR] 0.59; 95% confidence interval [CI] 0.35–0.98). Risk of dysfunctional labor increased with multiple micronutrient supplementation (RR 1.28; 95% CI, 1.01–1.60), although preterm premature rupture of membrane decreased (RR 0.40; 95% CI, 0.21–0.79). Puerperal sepsis was lower in those receiving folic acid–iron, folic acid–iron–zinc, and multiple micronutrients compared with controls ( P < 0.05). Conclusion Prenatal folic acid–iron supplementation reduced the risk of obstetric complications in this South Asian setting.