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Interventions to address maternal and childhood undernutrition: current evidence.

Nestle Nutrition Institute workshop series
January 1, 2014
Zulfiqar A Bhutta et al. (2 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the impact of Vitamin A supplementation (VAS) on reducing all-cause mortality and infant mortality.

Results Summary

Vitamin A supplementation reduced all-cause mortality by 24% and resulted in a 14% reduction in the risk of infant mortality at 6 months.

Population

Infants and young children (neonatal and child interventions).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (24)
InterventionDirectionEndpointPopulationDosageImpactClaim #
daily iron supplementation
decrease
incidence of anemia
women
69%
results in a reduction
#1
daily iron supplementation
decrease
incidence of low birthweight (LBW)
women
20%
results in a reduction
#2
daily iron supplementation
increase
mean birthweight
women
-
improves
#3
MMN supplementation during pregnancy
decrease
number of LBW infants
pregnant women
14%
significantly decrease
#4
MMN supplementation during pregnancy
decrease
small for gestational age (SGA)
pregnant women
13%
significantly decrease
#5
Balanced protein-energy supplementation
decrease
incidence of SGA
-
32%
reduces
#6
Balanced protein-energy supplementation
decrease
risk of stillbirths
-
38%
reduces
#7
Antimalarials
increase
mean birthweight
pregnant women
significantly
increase
#8
Antimalarials
decrease
LBW
pregnant women
43%
associated with a reduction
#9
Antimalarials
decrease
severe antenatal anemia
pregnant women
38%
associated with a reduction
#10
educational/counseling interventions
increase
exclusive breastfeeding
-
43% at 4-6 weeks
increased
#11
educational/counseling interventions
increase
exclusive breastfeeding
-
137% at 6 months
increased
#12
Vitamin A supplementation (VAS)
decrease
all-cause mortality
-
24%
reduces
#13
Vitamin A supplementation (VAS)
decrease
risk of infant mortality
-
14%
results in a reduction
#14
Intermittent iron supplementation
decrease
risk of anemia
children
49%
reduces
#15
Intermittent iron supplementation
decrease
iron deficiency
children
76%
reduces
#16
Intermittent iron supplementation
increase
hemoglobin concentration
children
-
significantly improves
#17
Intermittent iron supplementation
increase
ferritin concentration
children
-
significantly improves
#18
Preventive zinc supplementation
decrease
morbidity from childhood diarrhea
populations at risk of zinc deficiency
-
decreases
#19
Preventive zinc supplementation
decrease
morbidity from acute lower respiratory infections
populations at risk of zinc deficiency
-
decreases
#20
Preventive zinc supplementation
increase
linear growth
infants and young children
-
increases
#21
Preventive zinc supplementation
increase
weight gain
infants and young children
-
increases
#22
hand washing with soap
decrease
diarrhea morbidity
-
48%
significantly reduces
#23
water treatment
decrease
diarrhea morbidity
-
17%
reduction
#24
Abstract

The global burden of undernutrition remains high with little evidence of change in many countries. We reviewed the evidence of the potential nutritional interventions and estimated their effect on nutrition-related outcomes of women and children. Among the maternal interventions, daily iron supplementation results in a 69% reduction in incidence of anemia, 20% in incidence of low birthweight (LBW) and improves mean birthweight. MMN supplementation during pregnancy has been shown to significantly decrease the number of LBW infants by 14% and small for gestational age (SGA) by 13%. Balanced protein-energy supplementation reduces the incidence of SGA by 32% and risk of stillbirths by 38%. Antimalarials when given to pregnant women increase the mean birthweight significantly and were associated with a 43% reduction in LBW and severe antenatal anemia by 38%. Among the neonatal and child interventions, educational/counseling interventions increased exclusive breastfeeding by 43% at 4-6 weeks and 137% at 6 months. Vitamin A supplementation (VAS) reduces all-cause mortality by 24% and results in a 14% reduction in the risk of infant mortality at 6 months. Intermittent iron supplementation in children reduces the risk of anemia by 49% and iron deficiency by 76%, and significantly improves hemoglobin and ferritin concentration. Preventive zinc supplementation in populations at risk of zinc deficiency decreases morbidity from childhood diarrhea and acute lower respiratory infections, and increases linear growth and weight gain among infants and young children. Among the supportive interventions, hand washing with soap significantly reduces diarrhea morbidity by 48%, though it depends on access to water. The effect of water treatment on diarrhea morbidity also appears similarly large with a 17% reduction. Recent research has established linkages of preconception interventions with improved maternal, perinatal and neonatal health outcomes, and it has been suggested that several proven interventions recommended during pregnancy may be even more effective if implemented before conception. These proven interventions, if scaled up have the potential to reduce the global burden of undernutrition substantially.

Medical Subject Headings (MeSH)
AdultChildChild, PreschoolCost of IllnessDietary SupplementsFemaleGlobal HealthHumansInfantInfant, Low Birth WeightMalnutritionMicronutrientsPregnancyPregnancy Complications
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations12
Citations/Year1.1
Relative Citation Ratio0.50
NIH Percentile27%
Research Impact Scores
APT Score0.75
Weight Score1.57
Normalized Score0.70
Related Supplements
Interventions to address maternal and childhood undernutriti... | Panacea Index