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Maternal Nutrition, Infants and Children

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



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.


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.


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.


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.

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This study was supported by United Nations Children's Fund (Grant Number YH101-H12/03) through a cooperative agreement between UNICEF and the Centers for Disease Control and Prevention, Atlanta, US, and the National Natural Science of Foundation of China (Grant Number 30271131), Beijing, China. We are grateful to all the participants and their families who participated in the trial; the field-team members; Gong Aijing and Pan Yonghe who entered data. We thank the field supervisors Li Yanqing, Kang Yijun, Xing Yuan, Fang Bo, Liang Wei-feng, Wang Bei, Duan Sheng-gang and Shen Yuan who helped in the field procedures. This study has been registered as an International Standard Randomized Controlled Trial (Number ISRCTN08850194).

This study has been registered as an International Standard Randomized Controlled Trial (No. ISRCTN08850194).

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Correspondence to H Yan.

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Contributors: All authors contributed to the design and implementation of the study. WW coordinated the study, trained field stuff, supervised the quality control, collected data, cleaned, analyzed and interpreted the data, and drafted the manuscript. HY designed the study and supervised the field operation, data analysis, supervised the manuscript preparation and revised the paper. LZ developed the protocol and the field procedures, made substantial contributions to the execution and supervision of the field investigation. YC contributed to the supervision of the field investigation and data management. DW analysed the data independently and reviewed and revised the paper. QL helped the data analysis. All authors contributed to the manuscript and approved the final version.

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Wang, W., Yan, H., Zeng, L. et al. 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. Eur J Clin Nutr 66, 261–268 (2012).

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