For pregnant women, how do lipid-based nutrient supplements (LNSs) versus iron folic acid (IFA) affect maternal and infant outcomes?

2020 ◽  
Author(s):  
Ashraf Nabhan ◽  
Yasmeen Abuelnaga
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Infant Outcomes ◽  
Nutrient Supplements ◽  
Iron Folic Acid ◽  
Maternal And Infant Outcomes

Effect of routine iron–folic acid supplementation among rural pregnant women living in low- and high-groundwater-iron areas in Bangladesh

2019 ◽  
Vol 22 (15) ◽  
pp. 2844-2855 ◽  
Author(s):  
Faruk Ahmed ◽  
Moududur Rahman Khan ◽  
Ireen Akhtar Chowdhury ◽  
Rubhana Raqib ◽  
Anjan Kumar Roy ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Significant Proportion ◽  
Significant Risk ◽  
Folic Acid Supplementation ◽  
Fe Deficiency ◽  
Prospective Longitudinal Study ◽  
Iron Folic Acid ◽  
Hb Concentration ◽  
Prospective Longitudinal

AbstractObjective:The present study investigated the risks and benefits of routine Fe–folic acid (IFA) supplementation in pregnant women living in low- and high-groundwater-Fe areas in Bangladesh.Design:A case-controlled prospective longitudinal study design was used to compare the effect of daily Fe (60 mg) and folic acid (400 μg) supplementation for 3·5 months.Setting:A rural community in Bangladesh.Participants:Pregnant women living in low-groundwater-Fe areas (n 260) and high-groundwater-Fe areas (n 262).Results:Mean Hb and serum ferritin concentrations at baseline were significantly higher in pregnant women in the high-groundwater-Fe areas. After supplementation, the mean change in Hb concentration in the women in the low-groundwater-Fe areas (0·10 mg/dl) was higher than that in the pregnant women in the high-groundwater-Fe areas (–0·08 mg/dl; P = 0·052). No significant changes in the prevalence of anaemia or Fe deficiency (ID) in either group were observed after IFA supplementation; however, the prevalence of Fe-deficiency anaemia (IDA) decreased significantly in the women in the low-groundwater-Fe areas. The risk of anaemia, ID and IDA after supplementation did not differ significantly between the groups. None of the participants had Fe overload. However, a significant proportion of the women in the high- and low-groundwater-Fe areas remained anaemic and Fe-deficient after supplementation.Conclusion:IFA supplementation significantly increased the Hb concentration in pregnant women living in the low-groundwater-Fe areas. Routine supplementation with 60 mg Fe and 400 μg folic acid does not pose any significant risk of haemoconcentration or Fe overload. Further research to identify other nutritional and non-nutritional contributors to anaemia is warranted to prevent and treat anaemia.

scholarly journals Misdistributions of Iron-Folic Acid (IFA): a Major deterrent to combat Anemia in Pregnant Women

2015 ◽  
Author(s):  
Dr M.K. Sharma ◽  
◽  
Dr Neeraj Gour ◽  
Dr N.K. Goel ◽  
Dr Dinesh Walia ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Iron Folic Acid

scholarly journals Transitioning from Distribution of Iron-Folic Acid Supplements to Multiple Micronutrient Supplements for Pregnant Women (OR25-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Reina Engle-Stone ◽  
Stephen Vosti ◽  
Laura Meinzen-Dick ◽  
Sika Kumordzie
Keyword(s):  
Folic Acid ◽  
Preterm Birth ◽  
Cost Effectiveness ◽  
Burkina Faso ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Transition Costs ◽  
Multiple Micronutrient ◽  
Iron Folic Acid ◽  
The Cost

Abstract Objectives We aimed to estimate the potential effects, costs, and cost-effectiveness of a programmatic transition from distribution of iron-folic acid (IFA) tablets to distribution of multiple micronutrient supplements (MMS) to pregnant woman, using Bangladesh and Burkina Faso as case studies. Methods For each country, we developed an 11-year predictive model using baseline demographic information from the Lives Saved Tool and effect sizes from a recent meta-analysis of trials of MMS compared to IFA supplementation during pregnancy. We predicted the number of cases of stillbirth, infant mortality, and adverse birth outcomes (low birth weight, small-for-gestational age, and preterm birth) and DALYs averted by replacing IFA with MMS at current levels of IFA coverage (∼50% nationally in Bangladesh; ∼10% in Burkina Faso). We estimated initial program transition costs and the annual marginal cost of MMS compared to IFA supplements, and calculated cost-effectiveness measures for scenarios with varied numbers of tablets received and consumed by pregnant women. Results In Bangladesh, immediate replacement of IFA with MMS at current coverage (assuming all covered pregnancies receive 180 tablets) was predicted to avert >73,800 deaths and >178,500 cases of preterm birth over 11 years at a cost of $5.0 to $14.2 per DALY averted; costs would increase by ∼9% with the addition of programmatic transition costs. In Burkina Faso, the same scenario would avert >5700 deaths and >6600 cases of preterm birth over 11 years at a cost of $3.6 to $15.5 per DALY averted. Assuming that benefits of supplementation accrue only above a given threshold (e.g., 180 tablets per pregnancy), accounting for supplement consumption above or below this threshold (e.g., consumption of 30 tablets or 270 tablets) could substantially reduce the cost-effectiveness of the IFA-MMS switch in comparison with a scenario in which all covered pregnancies consume exactly 180 tablets, although cost per DALY averted remained below $105 in all scenarios. Conclusions This modeling analysis suggests that the cost per DALY averted by transitioning from IFA to MMS is low relative to other prenatal interventions designed to save lives. Improvements in program delivery and supplement adherence would improve the cost-effectiveness of replacing IFA with MMS. Funding Sources Sight and Life; Sackler Institute for Nutrition Science.

scholarly journals Identifying fear of childbirth in a UK population: qualitative examination of the clarity and acceptability of existing measurement tools in a small UK sample

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
P. Slade ◽  
K. Balling ◽  
K. Sheen ◽  
G. Houghton
Keyword(s):  
Pregnant Women ◽  
Content Validity ◽  
Cognitive Interview ◽  
Fear Of Childbirth ◽  
Infant Outcomes ◽  
General Anxiety ◽  
Measurement Tools ◽  
The Uk ◽  
Specific Fear ◽  
Maternal And Infant Outcomes

Abstract Background Fear of childbirth is related to but not synonymous with general anxiety, and represents a superior predictor for maternal and infant outcomes. There is a need to improve the identification and provision of support for women experiencing high fear of childbirth. However it is uncertain as to whether existing measurement tools have appropriate content validity (i.e. cover the relevant domains within the construct), practical utility, and whether they are acceptable for use with a UK population. This study aimed to (1) identify the utility and acceptability of existing measures of fear of childbirth (FOC) with a small UK sample and (2) map the content of existing measures to the key concepts of fear of childbirth established by previous research. Methods Ten pregnant women; five with high and five with low fear of childbirth participated in a cognitive interview covering four most commonly used measures of fear of childbirth: 1. The Wijma Delivery Expectancy Questionnaire (WDEQ A), 2. The Oxford Worries about Labour Scale (OWLS), 3. The Slade-Pais Expectations of Childbirth Scale – fear subscale (SPECS) and 4. The Fear of Birth scale (FOBS). Each measure was also reviewed by participants for ease and clarity of understanding and acceptability. The measures were then reviewed against the key domains identified in the fear of childbirth literature to ascertain the adequacy of content validity of each measure. Interviews were analysed using thematic analysis for each scale item. Results All measures except the FOBS, included items that either women did not understand or, if where there was understanding the meanings were inconsistent across women. All measures demonstrated limited acceptability and content validity for the specific construct of FOC. Therefore, none of the measurement tools currently used within the UK met criteria for understanding, acceptability and content validity for measurement of FOC. Conclusions Findings emphasise a need to develop a specific fear of childbirth tool with good clarity which demonstrates appropriate content validity, and that is acceptable in presentation and length for pregnant women in a UK population.

Maternal and Infant Outcomes With Concurrent Treatment of Tuberculosis and HIV Infection in Pregnant Women

2011 ◽  
Vol 56 (2) ◽  
pp. e63-e66 ◽  
Author(s):  
Patricia L Toro ◽  
Karen L Schneider ◽  
Rosalind J Carter ◽  
Elaine J Abrams ◽  
Wafaa M El-Sadr ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Concurrent Treatment ◽  
Infant Outcomes ◽  
Maternal And Infant Outcomes
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