Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries.,The Lancet

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Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries.
The Lancet ( IF 168.9 ) Pub Date : 2017-11-01 , DOI: 10.1016/s2214-109x(17)30371-6
Emily R Smith ₁ , Anuraj H Shankar ₂ , Lee S-F Wu ₃ , Said Aboud ₄ , Seth Adu-Afarwuah ₅ , Hasmot Ali ₃ , Rina Agustina ₆ , Shams Arifeen ₇ , Per Ashorn ₈ , Zulfiqar A Bhutta ₉ , Parul Christian ₃ , Delanjathan Devakumar ₁₀ , Kathryn G Dewey ₁₁ , Henrik Friis ₁₂ , Exnevia Gomo ₁₃ , Piyush Gupta ₁₄ , Pernille Kæstel ₁₂ , Patrick Kolsteren ₁₅ , Hermann Lanou ₁₆ , Kenneth Maleta ₁₇ , Aissa Mamadoultaibou ₁₈ , Gernard Msamanga ₁₉ , David Osrin ₁₀ , Lars-Åke Persson ₂₀ , Usha Ramakrishnan ₂₁ , Juan A Rivera ₂₂ , Arjumand Rizvi ₂₃ , H P S Sachdev ₂₄ , Willy Urassa ₄ , Keith P West ₃ , Noel Zagre ₂₅ , Lingxia Zeng ₂₆ , Zhonghai Zhu ₂₆ , Wafaie W Fawzi ₂₇ , Christopher R Sudfeld ₂₇

Affiliation

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Summit Institute of Development, Mataram, Indonesia.
The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana.
Summit Institute of Development, Mataram, Indonesia; Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
International Centre for Diarrhoeal Diseases Research Bangladesh (ICDDR,B), Dhaka, Bangladesh.
Centre for Child Health Research and Department of Paediatrics, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland.
Center for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
UCL Institute for Global Health, London, UK.
Department of Nutrition and Program in International and Community Nutrition, University of California-Davis, Davis, CA, USA.
Department of Nutrition Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Pediatrics, University College of Medical Sciences, Delhi, India.
Nutrition and Child Health Unit, Department of Public Health, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; Faculty of Bio-science engineering, Ghent University, Belgium.
Institut de Recherche en Sciences de la Santé, Ministry of Scientific Research and Innovation, Ouagadougou, Burkina Faso.
School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi.
Food and Agriculture Organization of the United Nations, Libreville, Gabon.
Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA.
Instituto Nacional de Salud Publica, Cuernavaca, Mexico.
Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
Pediatric and Clinical Epidemiology Unit, Sitar am Bhartia Institute of Science and Research, New Delhi, India.
UNICEF Regional Office for West and Central Africa, Dakar, Senegal.
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Micronutrient deficiencies are common among women in low-income and middle-income countries. Data from randomised trials suggest that maternal multiple micronutrient supplementation decreases the risk of low birthweight and potentially improves other infant health outcomes. However, heterogeneity across studies suggests influence from effect modifiers. We aimed to identify individual-level modifiers of the effect of multiple micronutrient supplements on stillbirth, birth outcomes, and infant mortality in low-income and middle-income countries.

中文翻译：

母亲补充多种微量营养素对死产、出生结局和婴儿死亡率影响的修正：对低收入和中等收入国家 17 项随机试验的个体患者数据进行荟萃分析。

微量营养素缺乏在低收入和中等收入国家的妇女中很常见。随机试验的数据表明，母亲补充多种微量营养素可降低低出生体重的风险，并可能改善婴儿的其他健康结果。然而，不同研究之间的异质性表明效果修饰剂的影响。我们的目的是确定多种微量营养素补充剂对低收入和中等收入国家死产、出生结局和婴儿死亡率影响的个体水平调节因素。

更新日期：2017-10-10

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