Iron and folic acid supplements and reduced early neonatal deaths in Indonesia
OBJECTIVE: To examine the relationship between antenatal care, iron and folic acid supplementation and tetanus toxoid vaccination during pregnancy in Indonesia and the risk of early neonatal death (death in days 0-6 of life). METHODS: We analysed pooled data on neonatal survival in singleton infants...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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The World Health Organization
2010-07-01
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000700009&lng=en&tlng=en |
| _version_ | 1797284124420997120 |
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| author | Christiana R Titaley Michael J Dibley Christine L Roberts John Hall Kingsley Agho |
| author_facet | Christiana R Titaley Michael J Dibley Christine L Roberts John Hall Kingsley Agho |
| author_sort | Christiana R Titaley |
| collection | DOAJ |
| description | OBJECTIVE: To examine the relationship between antenatal care, iron and folic acid supplementation and tetanus toxoid vaccination during pregnancy in Indonesia and the risk of early neonatal death (death in days 0-6 of life). METHODS: We analysed pooled data on neonatal survival in singleton infants born in the 5 years before each of the Indonesian demographic and health surveys of 1994, 1997 and 2002-2003. Only the most recently born infant of each mother was included. Multivariate Cox proportional hazards models were used to identify factors linked to early neonatal death. FINDINGS: Of the 40 576 infants included, 442 experienced early neonatal death. After adjustment, the risk of early neonatal death was significantly reduced for infants of mothers who received either any form of antenatal care (hazard ratio, HR: 0.48; 95% confidence interval, CI: 0.31-0.73), any quantity of iron and folic acid (HR: 0.53; 95% CI: 0.36-0.77) or > 2 tetanus toxoid injections (HR: 0.66; 95% CI: 0.48-0.92). When we analysed different combinations of these measures, iron and folic acid supplementation provided the main protective effect: early neonatal deaths were still significantly reduced among infants whose mothers received iron and folic acid supplements but no other form of antenatal care (HR: 0.10; 95% CI: 0.01-0.67), or the supplements but < 2 tetanus toxoid injections (HR: 0.46; 95% CI: 0.29-0.73). Subsequent analysis showed that 20% of early neonatal deaths in Indonesia could be attributed to a lack of iron and folic acid supplementation during pregnancy. CONCLUSION: Iron and folic acid supplementation during pregnancy in Indonesia significantly reduced the risk of early neonatal death and could also do so in other low- and middle-income countries. |
| first_indexed | 2024-03-07T17:43:30Z |
| format | Article |
| id | doaj.art-04a0ce195bee4e0a87f7462042ee00f9 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:43:30Z |
| publishDate | 2010-07-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-04a0ce195bee4e0a87f7462042ee00f92024-03-02T15:28:53ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862010-07-01887500508S0042-96862010000700009Iron and folic acid supplements and reduced early neonatal deaths in IndonesiaChristiana R Titaley0Michael J Dibley1Christine L Roberts2John Hall3Kingsley Agho4University of SydneyUniversity of SydneyUniversity of SydneyUniversity of New South WalesUniversity of Western SydneyOBJECTIVE: To examine the relationship between antenatal care, iron and folic acid supplementation and tetanus toxoid vaccination during pregnancy in Indonesia and the risk of early neonatal death (death in days 0-6 of life). METHODS: We analysed pooled data on neonatal survival in singleton infants born in the 5 years before each of the Indonesian demographic and health surveys of 1994, 1997 and 2002-2003. Only the most recently born infant of each mother was included. Multivariate Cox proportional hazards models were used to identify factors linked to early neonatal death. FINDINGS: Of the 40 576 infants included, 442 experienced early neonatal death. After adjustment, the risk of early neonatal death was significantly reduced for infants of mothers who received either any form of antenatal care (hazard ratio, HR: 0.48; 95% confidence interval, CI: 0.31-0.73), any quantity of iron and folic acid (HR: 0.53; 95% CI: 0.36-0.77) or > 2 tetanus toxoid injections (HR: 0.66; 95% CI: 0.48-0.92). When we analysed different combinations of these measures, iron and folic acid supplementation provided the main protective effect: early neonatal deaths were still significantly reduced among infants whose mothers received iron and folic acid supplements but no other form of antenatal care (HR: 0.10; 95% CI: 0.01-0.67), or the supplements but < 2 tetanus toxoid injections (HR: 0.46; 95% CI: 0.29-0.73). Subsequent analysis showed that 20% of early neonatal deaths in Indonesia could be attributed to a lack of iron and folic acid supplementation during pregnancy. CONCLUSION: Iron and folic acid supplementation during pregnancy in Indonesia significantly reduced the risk of early neonatal death and could also do so in other low- and middle-income countries.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000700009&lng=en&tlng=en |
| spellingShingle | Christiana R Titaley Michael J Dibley Christine L Roberts John Hall Kingsley Agho Iron and folic acid supplements and reduced early neonatal deaths in Indonesia Bulletin of the World Health Organization |
| title | Iron and folic acid supplements and reduced early neonatal deaths in Indonesia |
| title_full | Iron and folic acid supplements and reduced early neonatal deaths in Indonesia |
| title_fullStr | Iron and folic acid supplements and reduced early neonatal deaths in Indonesia |
| title_full_unstemmed | Iron and folic acid supplements and reduced early neonatal deaths in Indonesia |
| title_short | Iron and folic acid supplements and reduced early neonatal deaths in Indonesia |
| title_sort | iron and folic acid supplements and reduced early neonatal deaths in indonesia |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862010000700009&lng=en&tlng=en |
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