Evidence map›Paper›PMID 31605616›Full record

ArticleThe Journal of nutrition2020

The Effect of Maternal Multiple Micronutrient Supplementation on Female Early Infant Mortality Is Fully Mediated by Increased Gestation Duration and Intrauterine Growth.

Mary K Quinn, Emily R Smith, Paige L Williams, Willy Urassa, Joy Shi, Gernard Msamanga, Wafaie W Fawzi, Christopher R Sudfeld

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00197548 (A Trial of Micronutrients and Adverse Pregnancy Outcomes), which is not on this map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 25% 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.

NCT00197548 phase3completednot on this map

A Trial of Micronutrients and Adverse Pregnancy Outcomes

TypeinterventionalSponsorHarvard School of Public Health (HSPH)Ran2001 to 2006Enrolled8,468ConditionsPregnancy, Premature Birth, Infant, Low Birth Weight, Pregnancy OutcomesArmsMultivitamins-vitamins B-complex, C, and E, Placebo
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Observational
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 4 institutions in 2 countries.

Mary K QuinnDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Emily R SmithDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Paige L WilliamsDepartment of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA.
Willy UrassaDepartment of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Joy ShiDepartment of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
Gernard MsamangaDepartment of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Wafaie W FawziDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Christopher R SudfeldDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Harvard University · USMuhimbili University of Health and Allied Sciences · TZGates Foundation · USHarvard Global Health Institute · US

Funding

BIOSTATISTICS/EPIDEMIOLOGY TRAINING GRANTS IN AIDST32AI007358 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI Michael David Hughes · 1989 to 2026
$12.4M
NIAID NIH HHS T32 AI007358
6 · The paper itself

Abstract

backgroundMaternal micronutrient supplementation in pregnancy (MMS) has been shown to improve birth weight among infants in low- and middle-income countries. Recent evidence suggests that the survival benefits of MMS are greater for female infants compared to male infants, but the mechanisms leading to differential effects remain unclear.

objectiveThe objective of this study was to examine the potential mechanisms through which MMS acts on infant mortality among Tanzanian infants.

methodsWe used data collected from pregnant women and newborns in a randomized, double-blind, placebo-controlled trial of MMS conducted in Tanzania to examine mediators of the effect of MMS on 6-wk infant mortality (NCT00197548). Causal mediation analyses with the counterfactual approach were conducted to assess the contributions of MMS on survival via their effects on birth weight, gestational age, weight-for-gestational age, and the joint effect of gestational age and weight-for-gestational age. The weighting method allowed for interaction between gestational age and weight-for-gestational age.

resultsAmong 7486 newborns, the effect of MMS on 6-wk survival was fully mediated (100%) through the joint effect of gestational age and weight-for-gestational age. MMS was also found to have a significant natural indirect effect through increased birth weight (P-value < 0.001) that explained 75% of the total effect on 6-wk mortality. When analyses were stratified by sex, changes in gestational age and weight-for-gestational age fully mediated the mortality effect among female infants (n = 3570), but these mediators only explained 34% of the effect among males (n = 3833).

conclusionsThe potential sex-specific effects of MMS on mortality may be a result of differences in mechanisms related to birth outcomes. In the context of the Tanzanian trial, the observed effect of MMS on 6-wk mortality for female infants was entirely mediated by increased gestation duration and improved intrauterine growth, while these mechanisms did not appear to be major contributors among male infants.

Indexed as

Dietary SupplementsFetal DevelopmentInfant MortalityAdultFemaleHumansInfantMicronutrientsTanzaniaYoung AdultMicronutrientsbirth outcomesinfant mortalitymaternal nutritionmediationmultiple micronutrient supplementation

Identifiers

PMID31605616
PMCPMC7308623
OpenAlexW2979950679

What OpenQuestion holds

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Registered trials

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.