Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3954872 | International Journal of Gynecology & Obstetrics | 2009 | 5 Pages |
ObjectiveTo examine the effect of supplemental prenatal folic acid, folic acid–iron, folic acid–iron–zinc, and multiple micronutrients on maternal morbidity in rural Nepal.MethodsA 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.ResultsA 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).ConclusionPrenatal folic acid–iron supplementation reduced the risk of obstetric complications in this South Asian setting.