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Maternal Iron-and-Folic-Acid Supplementation and its Association with Low-birthweight and Neonatal Mortality in India
Authors: Rajesh Kumar Rai, Jan-Walter De Neve, Pascal Geldsetzer, Sebastian Vollmer
Source: Public Health Nutrition, DOI:10.1017/S1368980021004572
Topic(s): Anemia
Iron supplements
Country: Asia
Published: NOV 2021
Abstract: Objective: This study assessed intake of iron-and-folic-acid (IFA) tablet/syrup (grouped into none, <100 days of IFA consumption or <100 IFA, and =100 days of IFA consumption or =100 IFA) among prospective mothers and its association with various stages of low-birthweight (ELBW: extremely low-birthweight, VLBW: very low-birthweight, and LBW: low-birthweight) and neonatal mortality (death during day 0-1, 2-6, 7-27, and 0-27) in India. Design: The cross-sectional, nationally representative, 2015-2016 National Family Health Survey (NFHS-4) data were used. Weighted descriptive analysis, and multiple binary logistic regression modelling were used. Setting: NFHS-4 covered 640 districts from 37 states/ union territories of India. Participants: A total of 120,374 and 143,675 index children aged 0-59 months were included to analyse LBW and neonatal mortality, respectively. Results: Overall, 30.7% mothers consumed =100 IFA in 2015-2016, and this estimate ranged from 0.0% in Zunheboto district of Nagaland state to 89.5% in Mahe district of Puducherry of India. Multiple regression analysis revealed that children of mothers who consumed =100 IFA had lower odds of ELBW, VLBW, LBW, and neonatal mortality during day 0-1, as compared to mothers who did not buy/receive any IFA. Consumption of IFA (<100 IFA and =100 IFA) had protective association with neonatal death during day 7-27, and 0-27. Consumption of IFA was not associated with neonatal death during day 2-6. Conclusions: While =100 IFA consumption during pregnancy was found to be associated with preventing select types of LBW and neonatal mortality, a large variation in coverage of =100 IFA consumption across 640 districts is concerning.