Gupta Piyush, Ray Mily, Dua Tarun, Radhakrishnan Gita, Kumar Rajeev, Sachdev H P S
Department of Pediatrics, University College of Medical Sciences, Block R-6A, Dilshad Garden, Delhi 110095, India.
Arch Pediatr Adolesc Med. 2007 Jan;161(1):58-64. doi: 10.1001/archpedi.161.1.58.
To evaluate the effect of multimicronutrient supplementation for undernourished pregnant women on the birth size of their offspring, incidence of low-birth-weight infants (<2500 g), and early neonatal morbidity.
Randomized, double-blind, placebo-controlled trial.
Tertiary care hospital.
Two hundred pregnant women (of 13 465 approached) with a body mass index (calculated as weight in kilograms divided by the square of height in meters) of less than 18.5 and/or a hemoglobin level of 7 to 9 g/dL were enrolled at 24 to 32 weeks of gestation. One hundred forty-six neonates (73.0%) were available for analysis of birth size and 170 (85.0%) for analysis of morbidity in the 7 days after delivery. Intervention The micronutrient supplementation group (n = 99) received a multimicronutrient supplement containing 29 vitamins and minerals once a day, from enrollment until delivery (median duration, 58 days; interquartile range, 37-77 days; compliance, 87%). The comparison group (n = 101) received placebo for 52 (15-66) days, with 85% compliance. All subjects also received supplements of iron (given in the form of ferrous sulfate, containing 60 mg of elemental iron), 60 mg/d, and folic acid, 500 mug/d.
Birth weight, length, midarm circumference, incidence of low birth weight, and early neonatal morbidity.
Infants in the micronutrient group were heavier by 98 g (95% confidence interval [CI], -16 to 213 g) and measured 0.80 cm (95% CI, 0.03-1.57 cm) longer and 0.20 cm (95% CI, 0.04-0.36 cm) larger in midarm circumference compared with the placebo group. Incidence of low birth weight declined from 43.1% to 16.2% with multimicronutrient supplementation a (a 70% decrease; relative risk, 0.30; 95% CI, 0.13-0.71; P=.006), and that of early neonatal morbidity declined from 28.0% to 14.8% (a 58% decrease; relative risk, 0.42; 95% CI, 0.19-0.94; P=.04).
Compared with iron and folic acid supplementation, the administration of multimicronutrients to undernourished pregnant women may reduce the incidence of low birth weight and early neonatal morbidity.
评估补充多种微量营养素对营养不良孕妇后代出生体重、低出生体重儿（<2500 g）发生率及早期新生儿发病率的影响。
随机、双盲、安慰剂对照试验。
三级护理医院。
在妊娠24至32周时，纳入200名孕妇（在13465名接触的孕妇中），其体重指数（以千克体重除以身高米数的平方计算）小于18.5且/或血红蛋白水平为7至9 g/dL。146名新生儿（73.0%）可用于出生体重分析，170名（85.0%）可用于分娩后7天内的发病率分析。干预：微量营养素补充组（n = 99）从入组至分娩每天接受一次含29种维生素和矿物质的多种微量营养素补充剂（中位持续时间，58天；四分位间距，37 - 77天；依从性，87%）。对照组（n = 101）接受52（15 - 66）天的安慰剂，依从性为85%。所有受试者还接受铁补充剂（以硫酸亚铁形式给予，含60 mg元素铁），60 mg/d，以及叶酸，500 μg/d。
出生体重、身长、上臂围、低出生体重发生率及早期新生儿发病率。
与安慰剂组相比，微量营养素组婴儿体重重98 g（95%置信区间[CI]，-16至213 g），身长多0.80 cm（95% CI，0.03 - 1.57 cm），上臂围粗0.20 cm（95% CI，0.04 - 0.36 cm）。补充多种微量营养素后，低出生体重发生率从43.1%降至16.2%（降低70%；相对危险度，0.30；95% CI，0.13 - 0.71；P = 0.006），早期新生儿发病率从28.0%降至14.8%（降低58%；相对危险度，0.42；95% CI，0.19 - 0.94；P = 0.04）。
与补充铁和叶酸相比，对营养不良孕妇补充多种微量营养素可能降低低出生体重和早期新生儿发病率。
