A team effort between Australian and Chinese scientists could save the lives of many Chinese babies.
The team from the Xi'an Jiaotong University, The George Institute for International Health and Sydney University's School of Public Health, have been involved in a new study in China which has revealed the significant impact of iron supplements during pregnancy on preventing deaths in infants under four weeks of age.
The study was conducted over a four year period in two poor rural counties in northwest China, and set out to assess the impact of taking iron/folic acid and multiple micronutrient supplements containing 15 minerals and vitamins during pregnancy, compared with folic acid alone.
Lead investigator Professor Hong Yan from Xi'an Jiaotong University College of Medicine says the research demonstrates that nutrient supplements for pregnant women in developing countries need to have an adequate amount of iron to prevent premature births and reduce infant mortality.
The World Health Organisation (WHO) and the United Nations Children's Fund (UNICEF) have proposed the use of multiple micronutrient supplements during pregnancy, but this study found that although multiple micronutrients did improve birth weight more than iron folic acid, this greater increase in birth weight did not translate into reductions in infant deaths in the first month following birth.
Associate Professor Michael Dibley, from the School of Public Health and George Institute for International Health at Sydney University says after comparing the results with other studies in Indonesia, India, the United States, and Bangladesh, it appeared the reduction in neonatal mortality was related to the increased duration of pregnancy from the iron in the supplements.
China is the most populated developing country in the world, neonatal mortality accounts for more than 50% of the deaths of children under five - children with low birth weight are at a higher risk of death and one of the major causes of low birth weight in developing countries is the poor nutritional status of the mother before and during pregnancy.
Professor Dibley says it is estimated that 1.2 million low weight babies are born each year in China, but as yet there are no specific policies or programs for the distribution of multiple micronutrient or iron/folic acid supplements during pregnancy, even to disadvantaged women.
The research team collaborated with the local health services at county, township and village levels, and local government, in order to implement the study, an approach which has provided a suitable model to upscale the intervention on a larger scale in the future.
Professor Lingzhi Kong, the deputy director of disease control at China's Ministry of Health says the research will provide vital evidence to assist in the formulation of China's public health policy on nutrient supplementation in pregnancy, which will hopefully result in a significant reduction in the number of infant deaths.