An effectiveness trial of multiple micronutrient supplementation during pregnancy in Vietnam: impact on birthweight and on stunting in children at around 2 years of age.

BACKGROUND Multiple micronutrient deficiencies during pregnancy in Vietnam may contribute to poor fetal growth and stunting, which are major determinants of the health and development offuture generations. OBJECTIVE We assessed the effects of prenatal multiple micronutrient supplementation on maternal weight gain during pregnancy, infant birthweight, and height of the child at around 2 years of age. METHODS We conducted a nonrandomized, non-blinded, side-by-side effectiveness trial in a normal program setting in three districts in the Red River Delta in the north of Vietnam. Women in one district received the standard iron-folic acid supplement during prenatal care; women in the second district received the multiple micronutrient supplement; in the third district, gender training was provided in addition to the multiple micronutrient supplement. Cluster surveys were carried out in the three districts at the end of the trial to verify low birthweight (LBW) and at around 2 years after the trial to measure children's height and weight, as well as to collect demographic data on the mothers. RESULTS Mean birthweight was higher in the districts receiving multiple micronutrient supplements than in the district receiving iron-folic acid tablets. The mean birthweight was 166 g higher in the district receiving multiple micronutrients and 105 g higher in the district receiving multiple micronutrients with gender training than in the district receiving iron-folic acid (p < .05). The prevalence of LBW children (< 2500 g) was lower in the district receiving multiple micronutrients (4.0%) and the district receiving multiple micronutrients plus gender training (5.8%) than in the district receiving iron-folic acid (10.6%) (p < .05). Children at around 2 years of age were taller in the district receiving multiple micronutrients (82.66 cm) and the district receiving multiple micronutrients plus gender training (83.61 cm) than in the district receiving iron-folic acid (81.64 cm), and the stunting rates were about 10% lower than in the district receiving iron-folic acid. CONCLUSIONS Multiple micronutrient supplementation during pregnancy could be an important intervention to help reduce stunting rates in Vietnam.