DELHI, India—Compared with iron and folic acid supplementation, undernourished pregnant women taking multimicronutrients may reduce the incidence of low birth weight and early neonatal morbidity (Arch Pediatr Adolesc Med., 161:58-64, 2007). In a randomized, double blind, placebo-controlled trial, 200 pregnant women (at a tertiary care hospital) with a body mass index (BMI) 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. The women were divided in two groups, one group (n=99) received a micronutrient supplement containing 29 vitamins and minerals daily until delivery (median duration, 58 days; compliance, 87 percent). The other group (n=101) received a placebo (median duration, 52 days, 85-percent compliance). All women also received 60 mg/d iron, given in the form of ferrous sulfate, and folic acid, 500 µg/d. After birth, 146 neonates(73 percent) were available for size analysis, while 170 (85 percent) were included in morbidity analysis within seven days after delivery. Infants born of the micronutrient group were heavier (compared to placebo) by 98 g (95 percent confidence interval [CI], 16 to 213 g) and measured 0.80 cm (95 percent CI, 0.03-1.57 cm) longer and 0.20 cm (95 percent CI, 0.04-0.36 cm) larger in midarm circumference compared with the placebo group. Incidence of low birth weight declined from 43.1 percent to 16.2 percent with multimicronutrient supplementation—a 70-percent decrease. Relative risk, and that of early neonatal morbidity declined from 28 percent to 14.8 percent (a 58-percent decrease, relative risk, 0.42; 95 percent CI, 0.19-0.94; P=.04).
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