Society for Health and Demographic Surveillance, Suri, WB731101, India.
Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Public Health Nutr. 2022 Mar;25(3):623-633. doi: 10.1017/S1368980021004572. Epub 2021 Nov 8.
The current study assessed intake of iron-and-folic-acid (IFA) tablet/syrup (grouped into none, < 100 d of IFA consumption or < 100 IFA and ≥ 100 d of IFA consumption or ≥ 100 IFA) among prospective mothers and its association with various stages of low-birth weight (ELBW, extremely low-birth weight; VLBW, very low-birth weight and LBW, low-birth weight) and neonatal mortality (death during day 0-1, 2-6, 7-27 and 0-27) in India.
The cross-sectional, nationally representative, 2015-2016 National Family Health Survey (NFHS-4) data were used. Weighted descriptive analysis and multiple binary logistic regression modelling were used.
NFHS-4 covered 640 districts from thirty-seven states and union territories of India.
A total of 120 374 and 143 675 index children aged 0-59 months were included to analyse LBW and neonatal mortality, respectively.
Overall, 30·7 % mothers consumed ≥ 100 IFA in 2015-2016, and this estimate ranged from 0·0 % in Zunheboto district of Nagaland state to 89·5 % in Mahe district of Puducherry of India. Multiple regression analysis revealed that children of mothers who consumed ≥ 100 IFA had lower odds of ELBW, VLBW, LBW and neonatal mortality during day 0-1, as compared with mothers who did not buy/receive any IFA. Consumption of IFA (< 100 IFA and ≥ 100 IFA) had a protective association with neonatal death during day 7-27 and 0-27. Consumption of IFA was not associated with neonatal death during day 2-6.
While ≥ 100 IFA consumption during pregnancy was found to be associated with preventing select types of LBW and neonatal mortality, a large variation in coverage of ≥ 100 IFA consumption across 640 districts is concerning.
本研究评估了印度准母亲铁叶酸（IFA）片剂/糖浆的摄入情况（分为未摄入、摄入＜100 天或＜100 单位 IFA 但≥100 天或≥100 单位 IFA），及其与各种程度低出生体重（ELBW，极低出生体重；VLBW，非常低出生体重；LBW，低出生体重）和新生儿死亡（0-1、2-6、7-27 和 0-27 天死亡）的关联。
本研究使用了 2015-2016 年全国家庭健康调查（NFHS-4）的横断面、全国代表性数据。采用加权描述性分析和多元二项逻辑回归模型进行分析。
NFHS-4 覆盖了印度三十七个邦和联邦属地的 640 个地区。
共有 120374 名和 143675 名 0-59 月龄的指数儿童分别被纳入分析低出生体重和新生儿死亡。
总体而言，2015-2016 年有 30.7%的母亲摄入了≥100 单位的 IFA，这一估计值从那加兰邦宗霍佐特区的 0.0%到印度本地治里的迈赫区的 89.5%不等。多元回归分析显示，与未购买/未接受任何 IFA 的母亲相比，摄入≥100 单位 IFA 的母亲的婴儿发生 ELBW、VLBW、LBW 和 0-1 天内新生儿死亡的可能性较低。IFA 的摄入（＜100 IFA 和≥100 IFA）与 7-27 天和 0-27 天内的新生儿死亡具有保护相关性。IFA 的摄入与 2-6 天内的新生儿死亡无关。
虽然怀孕期间摄入≥100 单位的 IFA 与预防某些类型的低出生体重和新生儿死亡有关，但 640 个地区≥100 单位 IFA 摄入的覆盖范围存在很大差异，这令人担忧。
