TABLE 1.
Birth outcomes in multiple micronutrient and control groupsa
| Study | Mean ± SD birthweight (g) |
LBW (< 2,500 g) (%) |
SGA (within-cohort < 10th centile) (%) |
LGA (within-cohort > 90th centile) (%) |
Mean ± SD gestation (days) |
Preterm birth (< 37 wk) (%) |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|
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| MMN | Control | MMN | Control | MMN | Control | MMN | Control | MMN | Control | MMN | Control | |
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| Bangladesh [10] | 2,654 ± 399 n = 904 |
2,643 ± 427 n = 914 |
32.3 n = 904 |
35.7 n = 914 |
9.5 n = 901 |
10.5 n = 910 |
9.1 n = 901 |
10.9 n = 910 |
275 ± 14 n = 901 |
274 ± 15 n = 910 |
9.8 n = 901 |
12.7 n = 910 |
| China [11] | 3,208 ± 428 n = 1,364 |
3,189 ± 415 n = 1,418 |
3.3 n = 1,364 |
3.7 n = 1,418 |
9.6 n = 1,352 |
10.4 n = 1,415 |
10.2 n = 1,352 |
9.8 n = 1,415 |
279 ± 12 n = 1,352 |
279 ± 12 n = 1,415 |
4.1 n = 1,352 |
4.7 n = 1,415 |
| Indonesia (Indramayu) [12] |
3,086 ± 436 n = 726 |
3,081 ± 416 n = 709 |
6.9 n = 726 |
5.6 n = 709 |
9.4 n = 692 |
10.7 n = 676 |
11.1 n = 692 |
8.7 n = 676 |
269 ± 20 n = 692 |
270 ± 19 n = 676 |
27.9 n = 692 |
25.7 n = 676 |
| Indonesia (Lombok) [13] |
3,188 ± 485 n = 6,791 |
3,171 ± 490 n = 6,479 |
4.6 n = 6,791 |
5.3 n = 6,479 |
9.9 n = 6,492 |
10.2 n = 6,177 |
10.1 n = 6,492 |
9.7 n = 6,177 |
273 ± 19 n = 6,492 |
273 ± 19 n = 6,177 |
21.7 n = 6,492 |
21.0 n = 6,177 |
| Nepal (Sarlahi) [14] | 2,667 ± 432 n = 676 |
2,659 ± 429 n = 611 |
34.5 n = 676 |
33.2 n = 611 |
10.2 n = 648 |
9.8 n = 589 |
9.6 n = 648 |
10.4 n = 589 |
272 ± 18 n = 648 |
70 ± 19 n = 589 |
17.9 n = 648 |
21.1 n = 589 |
| Nepal (Janakpur) [15] |
2,809 ± 446 n = 500 |
2,733 ± 426 n = 496 |
19.2 n = 500 |
25.4 n = 496 |
8.8 n = 480 |
11.4 n = 483 |
12.5 n = 480 |
7.5 n = 483 |
275 ± 13 n = 480 |
276 ± 12 n = 483 |
8.1 n = 480 |
7.5 n = 483 |
| Pakistan [16] | 2,928 ± 568 n = 413 |
2,853 ± 521 n = 488 |
18.9 n = 413 |
21.1 n = 488 |
8.6 n = 372 |
11.4 n = 456 |
12.1 n = 372 |
8.1 n = 456 |
266 ± 20 n = 372 |
266 ± 21 n = 456 |
29.6 n = 372 |
29.4 n = 456 |
| Burkina Faso [17] | 2,919 ± 442 n = 493 |
2,889 ± 418 n = 494 |
14.6 n = 493 |
15.8 n = 494 |
9.8 n = 481 |
10.2 n = 488 |
10.6 n = 481 |
9.2 n = 488 |
273 ± 16 n = 481 |
274 ± 16 n = 488 |
13.9 n = 481 |
13.1 n = 488 |
| Guinea-Bissau [18] | 3,063 ± 524 n = 294 |
3,014 ± 460 n = 306 |
11.9 n = 294 |
12.7 n = 306 |
8.6 n = 279 |
11.3 n = 291 |
12.2 n = 279 |
7.9 n = 291 |
274 ± 21 n = 279 |
274 ± 20 n = 291 |
23.2 n = 279 |
22.3 n = 291 |
| Niger [19] | 3,106 ± 492 n = 1,214 |
3,033 ± 466 n = 1,107 |
6.9 n = 1,214 |
7.9 n = 1,107 |
9.1 n = 1,039 |
11.1 n = 937 |
10.9 n = 1,039 |
9.0 n = 937 |
263 ± 21 n = 1,039 |
264 ± 21 n = 937 |
41.9 n = 1,039 |
40.9 n = 937 |
| Zimbabwe [20] | 3,084 ± 430 n = 341 |
3,052 ± 426 n = 355 |
6.5 n = 341 |
9.0 n = 355 |
8.9 n = 325 |
11.1 n = 334 |
11.1 n = 325 |
8.6 n = 334 |
276 ± 15 n = 325 |
274 ± 17 n = 334 |
11.1 n = 325 |
14.7 n = 334 |
| Mexico [21] | 2,990 ± 380 n = 297 |
2,981 ± 403 n = 286 |
7.7 n = 297 |
8.7 n = 286 |
9.1 n = 296 |
11.0 n = 283 |
10.1 n = 296 |
9.5 n = 283 |
277 ± 14 n = 296 |
277 ± 15 n = 283 |
7.1 n = 296 |
6.4 n = 283 |
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| Pooled effect | + 22.4 g 95% CI, 8.3 to 36.4 g p = .002 |
OR = 0.89 95% CI, 0.81 to 0.97 p = .01 |
OR = 0.90 95% CI, 0.82 to 0.99 p = .03 |
OR = 1.13 95% CI, 1.00 to 1.28 p = .04 |
0.17 days 95% CI, − 0.35 to +0.70 p = .51 |
OR = 1.00 95% CI, 0.93 to 1.09 p = .9 |
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| Pooled adjusted effect |
+ 22.5 g 95% CI, 8.1 to 36.9 g p = .002 |
OR = 0.88 95% CI, 0.80 to 0.97 p = .01 |
OR = 0.90 95% CI, 0.82 to 0.99 p = .04 |
OR = 1.15 95% CI, 0.99 to 1.34 p = .06 |
0.11 days 95% CI, − 0.45 to + 0.68 p = .70 |
OR = 1.02 95% CI, 0.94 to 1.11 p = .7 |
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CI, confidence interval; LBW, low-birthweight; LGA, large-for-gestational age; MMN, multiple micronutrients; OR, odds ratio; SGA, small-for-gestational age
The following were excluded: women known to be HIV-positive, women known to have a multiple pregnancy, fetal losses before 28 weeks, stillbirths, infants with gestational age at delivery < 189 or > 314 days, and babies measured < 72 hours after birth. Only one pregnancy (the earliest) was included for each mother. Information on the age at which the baby was measured was not available for Burkina Faso, Zimbabwe, and Mexico. For outcomes including gestation (SGA, LGA, length of gestation, and preterm birth), women were excluded from the analysis if the gestational age was unlikely given the birthweight (see Statistical Methods). The pooled estimates are derived from random-effects meta-analysis, with adjustment for cluster design in six of the studies. Adjusted effects are further adjusted for maternal age and weight at recruitment, parity, and education and the sex of the baby.