No effect of maternal micronutrient supplementation on early childhood growth in rural western China: 30 month follow-up evaluation of a double blind, cluster randomized controlled trial.

BACKGROUND/OBJECTIVES: Little is known about the long-term effects of maternal multi-micronutrient supplementation on the growth of children during early childhood. In this follow-up study, the effects of maternal supplementation with multi-micronutrients in pregnancy on postnatal child growth are examined. SUBJECTS/METHODS: A longitudinal follow-up of a subset of newborns (n=1388) whose mothers were randomly assigned to receive the supplements of folic acid, iron-folic acid or multi-micronutrients daily during pregnancy in the original trial was conducted. Children's weight and length were measured and assessed during monthly home visits from birth to 30 months of age. RESULTS: The pooled prevalence rate of stunting over different time points during the first 30 months was 13.5, 14.9 and 12.1% for the folic acid group, iron-folic acid group and multi-micronutrient group, respectively. However, there were no significant differences in the pooled odds of stunting in children between the multi-micronutrient group and the folic acid (odds ratio (OR) 0.97, 95% confidence interval (CI): 0.74-1.26), and between the multi-micronutrient group and the iron-folic acid group (OR 0.82, 95% CI: 0.63-1.07). Similar results for the three groups were found for the occurrences of underweight and wasting in children. Furthermore, no significant differences were observed in length, weight, length-for-age, weight-for-age and weight-for-length Z-scores among the three treatment groups. CONCLUSIONS: Currently, available evidence is insufficient to support a greater advantage of the effect of maternal multi-micronutrient supplementation on child growth over iron-folic acid or folic acid only supplementation during the first 30 months.