In the United States medical researchers probably can’t put poor black or brown women into three groups, give them different pre-natal supplements (MMS, multiple micronutrient supplementation vs iron-folic acid using either 60-mg or 30-mg iron formulations), and then wait to see what would happen to the babies in a few years. But it can still be done in Bangladesh.
I was given pre-natal vitamins (huge horse pills) as soon as I knew I was pregnant in 1961. I knew without being told just from my upbringing that I needed to eat healthy; I stopped drinking coffee (made me sick). I went back to drinking milk every day. I gained very little weight. However, in poor countries it is harder to eat better.
The surprising thing about “Effects of prenatal micronutrient and early food supplementation” research published in the May 16, 2012 JAMA is that although by age 5, the children in one group of the multiple micronutrient study were healthier, fewer of them actually made it to term. The special supplements (of any of the 3 types) had few or no benefits on birth length, weight or reducing still birth.
Mortality rates for offspring were highest among the women randomized to MMS combined with the usual invitation to food supplementation, mainly caused by asphyxia. Furthermore, this treatment group had significantly higher incidence of spontaneous abortions. The late pregnancy losses were lower in the usual invitation with MMS group, resulting in no difference in RR of total fetal loss across treatment groups.
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