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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Iron and folic acid supplements in pregnancy improve child survival in Indonesia
American Journal of Clinical Nutrition, Volume 95, No. 1, Year 2012
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Description
Background: Several trials have shown that iron-folic acid supplements during pregnancy protect newborns against preterm delivery and early neonatal death, but the impact beyond the neonatal period is unclear. Objective: We determined whether live-born children <5 y of age born to mothers who used antenatal iron-folic acid supplements had reduced risk of death. Design: Pooled 1994, 1997, 2002-2003, and 2007 Indonesia Demographic and Health Survey data were used to examine the relation between the use of iron-folic acid supplements and child death in 3 cumulative (0-30 d, 0-11 mo, and 0-4 y) and 4 mutually exclusive (first day of life and 1-30 d, 1-11 mo, and 1-4 y of age) time periods. Risk of death was estimated by using Cox regression to control for 19 potential confounders. Results: Survival information for 52,917 singleton live-born infants and 1525 deaths of children <5 y of age was examined. After adjustment for potential confounders, risk of death of children <5 y of age was reduced significantly by 34% if the mother consumed any iron-folic acid supplements [adjusted HR (aHR): 0.66; 95% CI: 0.53, 0.81; P < 0.001]. This protective effect was greatest for deaths on the first day of life (aHR: 0.40; 95% CI: 0.21, 0.77; P = 0.005) but was also shown for neonatal deaths on days 1-30 of life (aHR: 0.69; 95% CI: 0.49, 0.97; P = 0.035) and postneonatal deaths (aHR: 0.74; 95% CI: 0.56, 0.99; P = 0.044). There was a strong dose response of greater protection from death of children <5 y of age with increasing numbers of iron-folic acid supplements consumed. Conclusion: In developing countries increased use of antenatal iron-folic acid supplements will reduce deaths of children <5 y of age, especially in the first year of life. © 2012 American Society for Nutrition.
Authors & Co-Authors
Dibley, Michael John
Australia, Sydney
The University of Sydney
Titaley, Christiana Rialine
Indonesia, Depok
Universitas Indonesia
D'Este, Catherine A.
Australia, Callaghan
University of Newcastle, College of Health, Medicine and Wellbeing
Agho, Kingsley Emwinyore
Australia, Penrith
Western Sydney University
Statistics
Citations: 31
Authors: 4
Affiliations: 4
Identifiers
Doi:
10.3945/ajcn.111.022699
ISSN:
19383207
Research Areas
Food Security
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Approach
Quantitative