Antenatal Iron-folic Acid Supplementation Reduces Risk of Low Birth Weight in Pakistan.

ABSTRACT

Objectives: To examine the effect of iron-folic acid (IFA) supplementation on perceived birth size and birth weight using Pakistan Demographic and Health Survey (PDHS) 2006-07. Methods: Information from 5,692 most recent live-born infants within 5 years prior to survey was used. The primary outcomes were maternal perception of birth size and birth weight and the main exposure was any use of antenatal IFA supplements. Birth weight was reported for only 10% of live births in PDHS 2006-07. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Analyses used multivariate logistic regression adjusted for 14 potential confounders. Results: The risk of having less than average birth size babies was significantly reduced by 18% (aOR 0.82, 95% CI 0.71, 0.96) for mothers who used any IFA supplements compared to no IFA use. A similar (18%), but non-significant reduction in the risk of low birth weight babies was found with maternal use of IFA supplements. Mothers who started IFA in the first trimester of pregnancy, significantly reduced the risk of having less than average birth size babies by 19%. Population attributable risk estimates showed 11% of ‘less than average birth size’ were attributed to non-use of antenatal IFA supplementation and universal coverage of IFA supplementation could prevent 112,000 newborns to have ‘less than average birth size’ each year in Pakistan. Conclusions: Antenatal IFA supplementation significantly reduces the risk of less than average birth size and low birth weight babies in Pakistan. Universal coverage of supplementation improves birth size.