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Relative efficacy of micronutrient powders versus iron-folic acid tablets in controlling anemia in women in the second trimester of pregnancy.
Food Nutr Bull. 2012 Jun; 33(2):142-9.FN

Abstract

BACKGROUND

Iron deficiency is a major cause of anemia and the most prevalent nutrient deficiency among pregnant women in developing countries. The use of iron and folic acid supplements to treat and prevent iron-deficiency anemia has limited effectiveness, mainly due to poor adherence. Home fortification with a micronutrient powder for pregnant women may be an effective and acceptable alternative to traditional drug models.

OBJECTIVE

To determine whether home fortification with micronutrient powders is at least as efficacious as iron and folic acid tablets for improving hemoglobin concentration in pregnant women.

METHODS

A cluster-randomized noninferiority trial was conducted in the rural subdistrict of Kaliganj in central Bangladesh. Pregnant women (gestational age 14-22 weeks, n=478), were recruited from 42 community-based Antenatal Care Centres. Each centre was randomly allocated to receive either a micronutrient powder (containing iron,folic acid, vitamin C, and zinc) or iron and folic acid tablets. Changes in hemoglobin from baseline were compared across groups using a linear mixed-effects regression model.

RESULTS

At enrolment, the overall prevalence of anemia was 45% (n = 213/478). After the intervention period, the mean hemoglobin concentrations among women receiving the micronutrient powder were not inferior to those among women receiving tablets (109.5 ± 12.9 vs. 112.0 ± 11.2 g/L; 95% CI, -0.757 to 5.716). Adherence to the micronutrient powder was lower than adherence to tablets (57.5 ± 22.5% vs. 76.0 ± 13.7%; 95% CI, -22.39 to -12.94); however, in both groups, increased adherence was positively correlated with hemoglobin concentration.

CONCLUSIONS

The micronutrient powder was at least as efficacious as the iron and folic acid tablets in controlling moderate to severe anemia during pregnancy.

Authors+Show Affiliations

Research and Evaluation Division, Bangladesh Rural Advancement Committee, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22908696

Citation

Choudhury, Nuzhat, et al. "Relative Efficacy of Micronutrient Powders Versus Iron-folic Acid Tablets in Controlling Anemia in Women in the Second Trimester of Pregnancy." Food and Nutrition Bulletin, vol. 33, no. 2, 2012, pp. 142-9.
Choudhury N, Aimone A, Hyder SM, et al. Relative efficacy of micronutrient powders versus iron-folic acid tablets in controlling anemia in women in the second trimester of pregnancy. Food Nutr Bull. 2012;33(2):142-9.
Choudhury, N., Aimone, A., Hyder, S. M., & Zlotkin, S. H. (2012). Relative efficacy of micronutrient powders versus iron-folic acid tablets in controlling anemia in women in the second trimester of pregnancy. Food and Nutrition Bulletin, 33(2), 142-9.
Choudhury N, et al. Relative Efficacy of Micronutrient Powders Versus Iron-folic Acid Tablets in Controlling Anemia in Women in the Second Trimester of Pregnancy. Food Nutr Bull. 2012;33(2):142-9. PubMed PMID: 22908696.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative efficacy of micronutrient powders versus iron-folic acid tablets in controlling anemia in women in the second trimester of pregnancy. AU - Choudhury,Nuzhat, AU - Aimone,Ashley, AU - Hyder,S M Ziauddin, AU - Zlotkin,Stanley H, PY - 2012/8/23/entrez PY - 2012/8/23/pubmed PY - 2012/9/7/medline SP - 142 EP - 9 JF - Food and nutrition bulletin JO - Food Nutr Bull VL - 33 IS - 2 N2 - BACKGROUND: Iron deficiency is a major cause of anemia and the most prevalent nutrient deficiency among pregnant women in developing countries. The use of iron and folic acid supplements to treat and prevent iron-deficiency anemia has limited effectiveness, mainly due to poor adherence. Home fortification with a micronutrient powder for pregnant women may be an effective and acceptable alternative to traditional drug models. OBJECTIVE: To determine whether home fortification with micronutrient powders is at least as efficacious as iron and folic acid tablets for improving hemoglobin concentration in pregnant women. METHODS: A cluster-randomized noninferiority trial was conducted in the rural subdistrict of Kaliganj in central Bangladesh. Pregnant women (gestational age 14-22 weeks, n=478), were recruited from 42 community-based Antenatal Care Centres. Each centre was randomly allocated to receive either a micronutrient powder (containing iron,folic acid, vitamin C, and zinc) or iron and folic acid tablets. Changes in hemoglobin from baseline were compared across groups using a linear mixed-effects regression model. RESULTS: At enrolment, the overall prevalence of anemia was 45% (n = 213/478). After the intervention period, the mean hemoglobin concentrations among women receiving the micronutrient powder were not inferior to those among women receiving tablets (109.5 ± 12.9 vs. 112.0 ± 11.2 g/L; 95% CI, -0.757 to 5.716). Adherence to the micronutrient powder was lower than adherence to tablets (57.5 ± 22.5% vs. 76.0 ± 13.7%; 95% CI, -22.39 to -12.94); however, in both groups, increased adherence was positively correlated with hemoglobin concentration. CONCLUSIONS: The micronutrient powder was at least as efficacious as the iron and folic acid tablets in controlling moderate to severe anemia during pregnancy. SN - 0379-5721 UR - https://www.unboundmedicine.com/medline/citation/22908696/Relative_efficacy_of_micronutrient_powders_versus_iron_folic_acid_tablets_in_controlling_anemia_in_women_in_the_second_trimester_of_pregnancy_ L2 - https://journals.sagepub.com/doi/10.1177/156482651203300208?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -