- Title
- Iron and folic acid supplements in pregnancy improve child survival in Indonesia
- Creator
- Dibley, Michael J.; Titaley, Christiana R.; d'Este, Catherine; Agho, Kingsley
- Relation
- American Journal of Clinical Nutrition Vol. 95, Issue 1, p. 220-230
- Publisher Link
- http://dx.doi.org/10.3945/ajcn.111.022699
- Publisher
- American Society for Nutrition
- Resource Type
- journal article
- Date
- 2012
- 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.
- Subject
- iron and folic acid supplements; iron; folic acid; Indonesia; pregnancy; child survival; preterm delivery; neonatal
- Identifier
- http://hdl.handle.net/1959.13/1061354
- Identifier
- uon:16936
- Identifier
- ISSN:0002-9165
- Language
- eng
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