March 05, 2020, Shanghai – Recently the result of a retrospective cohort study on adverse pregnancy outcomes in women supplemented with multiple micronutrients is published in the latest ‘Chinese Journal of Practical Gynecology & Obstetrics’. The aim of the study initiated by Professor Liu Xinghui, Department of Gynecology & Obstetrics from West China Second University Hospital of Sichuan University was to determine whether multi-micronutrient (MMN) supplementation had additional preventive effects on pregnancy outcomes. This published conclusion of the study showed that supplementation with multiple micronutrient (MMN) during pregnancy can significantly reduce the risk of adverse pregnancy outcomes, especially in the first trimester of pregnancy.
In this multicenter, cohort study, the physicians retrospectively obtained clinical data from pregnant women hospitalized and delivered in four hospitals in China. The pregnant women from the four hospitals included in the study received routine iron supplementation and anemia correction according to the ‘Guidelines for Diagnosis and Treatment of Iron Deficiency and Iron Deficiency Anemia in Pregnancy’. According to whether the subjects took the MMN regularly during pregnancy, they were divided into two groups: the group taking the MMN and the group not taking the multivitamin; according to the starting time of taking the MMN, they were divided into the group taking the multivitamin in the first trimester of pregnancy and the group not taking the multivitamin in the first trimester of pregnancy. Among them, taking MMN refers to taking only Elevit as single MMN during pregnancy, and the MMN taking time is > = 1 month; not taking MMN refers to taking only folic acid during pregnancy and not taking any other brands of MMN.
In total, 8286 pregnant women were included; 5301 (64%) had used an MMN supplement and 2985 (36.0%) had used folic acid alone. Compared with folic acid alone, MMN supplementation during any stage of pregnancy significantly reduced the risk of iron-deficiency anemia (1.2% vs. 25.3%), preeclampsia (0.5% vs. 1.2%), macrosomia (3.8% vs. 4.8%), and postpartum hemorrhage (3.2% vs. 7.9%). MMN supplementation during the first trimester significantly reduced the risk of iron-deficiency anemia (1.3% vs. 17.6%), preeclampsia (0.3% vs. 1.1%), intrahepatic cholestasis of pregnancy (3.4% vs. 5.3), postpartum hemorrhage (3.8% vs. 5.8%), premature birth ( 3.7% vs. 5.4%), and low birthweight ( 2.7% vs. 3.7%) compared with those who did not use MMN supplementation in the first trimester.
This retrospective cohort study showed that supplementation with MMN during pregnancy can significantly reduce the risk of adverse pregnancy outcomes compared with not taking MMN, especially in the first trimester of pregnancy.
According to statistics, the incidence of iron deficiency anemia in pregnant women in China is 19.1%. Iron supplement to the mother can increase the iron reserve of the mother. It is also recommended in ‘China's Guide to Preconception and Prenatal Care’ that non anemic pregnant women, such as serum ferritin < 30 μ g / L, should be supplemented with 60 mg / day of iron. WHO recommends that pregnant women should intake 30-60mg iron every day. In this study, the iron content of the MMN taken by pregnant women is 60mg, which has met the needs of most pregnant women in China. Therefore, the supplementation of MMN during pregnancy has a significant preventive effect on iron deficiency anemia during pregnancy.
Pregnancy is a special period in women's life and nutrition has vital roles throughout all stages of pregnancy, and the nutritional demands of the developing embryo and fetus increases micronutrient requirements (e.g. folic acid, calcium, copper, iron) in the mother during pregnancy. Previous studies have also shown that the lack of nutrients can lead to obstetric complications and birth defects. However, due to the lack of the relevant clinical data we heard some discussion on the necessary of MMN supplementation. Furthermore, despite the greater micronutrient demand in pregnant women, actual intake is often insufficient, leading to an absolute or relative insufficiency of multiple vitamins and minerals that can alter both maternal and fetal metabolism and influence pregnancy outcomes.
We are convinced that the newly published study will help people pay more attention to the nutrition and better understand the vital important role the multiple vitamins and minerals play to reduce the risk of adverse pregnancy outcomes.
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