Effects of antenatal multiple micronutrient supplementation on birth weight and gestational duration in Nepal


Mother and Infant Research Activities (MIRA), Nepal

A third of all deaths happen in children younger than five years, mostly in the first weeks after birth.

Low birth weight (<2.5 Kg) causes many of these deaths. 25 million low birth weight infants are born every year. Antenatal multivitamin and mineral supplements could increase infant birth weight and prevent some of these deaths.

What we are doing

This project compares the impact of micronutrient supplements on pregnancy outcome with outcome in women who only took folic acid and iron. The test pill contains a combination of the recommended daily allowances of ten vitamins and five minerals.

Supplementation begins at about four months’ gestation and lasts until delivery. Results indicate that average birth weight was 77 grams higher in the test group than the control group, while the proportion of low birth weight babies was 25 percent lower.

We found no difference between the two groups in terms of the duration of pregnancy, illness or problems during pregnancy. Many women in both rich and poor countries take iron and folic acid supplements during pregnancy and only small policy changes would be needed to change this to a multivitamin and mineral supplement.

However, analysis of our data in conjunction with another supplementation study in Nepal has raised the possibility that, in addition to the beneficial impact on birthweight, there may also be unexpected effects on perinatal mortality.

Results from a number of international studies are currently being looked at together to assess the overall risk/benefit of this type of intervention.