No effect of maternal micronutrient supplementation on early childhood growth in rural western China: 30 month follow-up evaluation of a double blind, cluster randomized controlled trial.

BACKGROUND/OBJECTIVES: Little is known about the long-term effects of maternal multi-micronutrient supplementation on the growth of children during early childhood. In this follow-up study, the effects of maternal supplementation with multi-micronutrients in pregnancy on postnatal child growth are examined.

SUBJECTS/METHODS: A longitudinal follow-up of a subset of newborns (n=1388) whose mothers were randomly assigned to receive the supplements of folic acid, iron-folic acid or multi-micronutrients daily during pregnancy in the original trial was conducted. Children's weight and length were measured and assessed during monthly home visits from birth to 30 months of age.

RESULTS

The pooled prevalence rate of stunting over different time points during the first 30 months was 13.5, 14.9 and 12.1% for the folic acid group, iron-folic acid group and multi-micronutrient group, respectively. However, there were no significant differences in the pooled odds of stunting in children between the multi-micronutrient group and the folic acid (odds ratio (OR) 0.97, 95% confidence interval (CI): 0.74-1.26), and between the multi-micronutrient group and the iron-folic acid group (OR 0.82, 95% CI: 0.63-1.07). Similar results for the three groups were found for the occurrences of underweight and wasting in children. Furthermore, no significant differences were observed in length, weight, length-for-age, weight-for-age and weight-for-length Z-scores among the three treatment groups.

CONCLUSIONS

Currently, available evidence is insufficient to support a greater advantage of the effect of maternal multi-micronutrient supplementation on child growth over iron-folic acid or folic acid only supplementation during the first 30 months.