Evidence map›Paper›PMID 27306908›Full record

SynthesisBMC medicine2016

Maternal antenatal multiple micronutrient supplementation for long-term health benefits in children: a systematic review and meta-analysis.

Delan Devakumar, Caroline H D Fall, Harshpal Singh Sachdev, Barrie M Margetts, Clive Osmond, Jonathan C K Wells, Anthony Costello, David Osrin

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 7 pooled it
12.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 7 syntheses or guidelines pooled it, 111 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Delan DevakumarInstitute for Global Health, University College London, 30 Guilford St, London, UK. d.devakumar@ucl.ac.uk.
Caroline H D FallMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK.
Harshpal Singh SachdevPediatrics and Clinical Epidemiology at Sitaram Bhartia Institute of Science and Research, B-16, Qutab Institutional Area, New Delhi, India.
Barrie M MargettsFaculty of Medicine, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK.
Clive OsmondMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK.
Jonathan C K WellsChildhood Nutrition Research Centre, Institute of Child Health, University College London, 30 Guilford St, London, UK.
Anthony CostelloInstitute for Global Health, University College London, 30 Guilford St, London, UK.
David OsrinInstitute for Global Health, University College London, 30 Guilford St, London, UK.
George Institute for Global Health · GBUniversity College London · GBUniversity of Southampton · GBSitaram Bhartia Institute of Science and Research · INSouthampton General Hospital · GB

Funding

Medical Research Council G0400519Medical Research Council MC_U147574242Medical Research Council MC_UP_A620_1016Medical Research Council MC_UU_12011/3Wellcome Trust
6 · The paper itself

Abstract

backgroundMultiple micronutrient supplementation for pregnant women reduces low birth weight and has been recommended in low- and middle-income countries (LMICs) to improve child survival, growth and health. We aimed to review the evidence from long-term follow-up studies of multiple micronutrient supplementation beginning in the later first or second trimester.

methodsWe searched systematically for follow-up reports from all trials in a 2015 Cochrane review of multiple micronutrient supplementation in pregnancy. The intervention comprised three or more micronutrients and the comparison group received iron (60 mg) and folic acid (400 μg), where possible. Median gestation of commencement varied from 9 to 23 weeks. Primary outcomes were offspring mortality, height, weight and head circumference, presented as unadjusted differences in means or proportions (intervention minus control). Secondary outcomes included other anthropometry, body composition, blood pressure, and cognitive and lung function.

resultsWe found 20 follow-up reports from nine trials (including 88,057 women recruited), six of which used the UNIMMAP supplement designed to provide recommended daily allowances. The age of follow-up ranged from 0 to 9 years. Data for mortality estimates were available from all trials. Meta-analysis showed no difference in mortality (risk difference -0.05 per 1000 livebirths; 95 % CI, -5.25 to 5.15). Six trials investigated anthropometry and found no difference at follow-up in weight-for-age z score (0.02; 95 % CI, -0.03 to 0.07), height-for-age z score (0.01; 95 % CI, -0.04 to 0.06), or head circumference (0.11 cm; 95 % CI, -0.03 to 0.26). No differences were seen in body composition, blood pressure, or respiratory outcomes. No consistent differences were seen in cognitive function scores.

conclusionsThere is currently no evidence that, compared with iron and folic acid supplementation, routine maternal antenatal multiple micronutrient supplementation improves childhood survival, growth, body composition, blood pressure, respiratory or cognitive outcomes.

Indexed as

Dietary SupplementsPrenatal Exposure Delayed EffectsAdultFemaleFolic AcidHumansInfant, NewbornIronMicronutrientsPregnancyFolic AcidIronMicronutrientsChildMicronutrientsPrenatal exposure delayed effects

Identifiers

PMID27306908
PMCPMC4910255
OpenAlexW2442012631

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.