One of the biggest risks to newborns is to be born too early and too small. And doctors don't know why some babies are born prematurely. It's one of the most vexing problems in the field of medicine. These babies are at much greater risk of death and disability, and their care is often long and expensive. Now some new research has found one low-tech way to reduce the number of low-birth-weight babies.
Neonatologist Prakesh Shah wondered if the mother's prenatal diet could be a factor. He and colleagues from the University of Toronto wanted to know if it's best for women to take a daily multivitamin during pregnancy or to take daily supplements of folic acid combined with iron - as recommended by the World Health Organization. They combed through research papers that had examined this question in thousands of women, and he aggregated the data.
"And [we] found out that there were 13 studies that were published, looking at this particular aspect and comparing women in two groups … one group taking multivitamins and another group taking iron-folic acid alone," Shah says. "And there were another set of studies in which women [taking] multivitamins [were] compared to [those taking a] placebo alone."
In all, Shah synthesized data on more than 36,000 women and their babies. He says the conclusion was unequivocal. Taking multivitamins - which include iron and folic acid and also other nutrients - reduced the chance of a woman having a low-birth-weight baby by 17 percent.
"So if you look at the world, in the world there are 135 million babies born every year, and of those, 20 million babies are low birth weight…That's a lot of babies," Shah says. "But if every woman gets multivitamins, we will reduce that number by 1.5 million every year... worldwide."
Shah says it's time the WHO updates its recommendations for prenatal nutrition.
"We don't need to do more and more studies because… it's not ethical to get the women now to take only iron-folic acid and being part of the study," Shah says. "So we are challenging the WHO that we need to create a policy change..."
The capacity for mass distribution of multivitamins exists. In many countries, local health departments already distribute iron and folic acid supplements. Shah says the cost of distributing multivitamins will be only slightly more, but it's a cost that will be outweighed by the subsequent reduction in low-birth-weight babies.
Shah's research is published in the Canadian Medical Association Journal.