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 b...

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Publicado en:Bulletin of the World Health Organization Vol. 88; no. 7; pp. 500 - 509
Autores principales: Titaley CR, Dibley MJ, Roberts CL, Hall J, Agho K
Formato: research tables/charts Journal Article
Publicado: World Health Organization Jul2010
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2010
      vid: 88
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        atl: Iron and folic acid supplements and reduced early neonatal deaths in Indonesia.
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        au:
          Titaley CR
          Dibley MJ
          Roberts CL
          Hall J
          Agho K
        affil: Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, NSW 2006, Australia; citaley@health.usyd.edu.au
      sug:
        subj:
          Folic Acid Administration and Dosage
          Infant Mortality Trends
          Iron Compounds Administration and Dosage
          Tetanus Toxoid Administration and Dosage
          Confidence Intervals
          Cox Proportional Hazards Model
          Data Analysis Software
          Data Analysis, Statistical
          Descriptive Statistics
          Female
          Funding Source
          Human
          Indonesia
          Infant, Newborn
          Multiple Logistic Regression
          Obstetric Care
          Pregnancy
          Infant, Newborn: birth-1 month
          Female
      ab: 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. © World Health Organization 2010. All rights reserved.
      pubtype: Academic Journal
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      ougenre: Article
    language: English
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