Multiple micronutrient powders for home (point of use) fortification of foods in pregnant women: a systematic review


Background: It is estimated that 32 million pregnant women suffer from anaemia worldwide. Due to increased metabolic demands, pregnant women are particularly vulnerable to anaemia and vitamin and mineral deficiencies, leading to adverse health effects in both the mother and her baby. Despite the demonstrated benefits of prenatal supplementation with iron and folic acid or multiple micronutrients, poor adherence to routine supplementation has limited the effectiveness of this intervention in many settings. Micronutrient powders for point‐of‐use fortification are packed, single‐dose sachets containing vitamins and minerals that can be added onto prepared food to improve its nutrient profile. The use of multiple micronutrient powders for point‐of‐use fortification of foods in pregnant women could be an alternative intervention to prenatal micronutrient supplementation.

Objectives: To assess the effects of prenatal home (point‐of‐use) fortification of foods with multiple micronutrient powders on maternal and newborn health.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015) and the International Clinical Trials Registry Platform (ICTRP) (31 January 2015). We also contacted relevant agencies to identify ongoing and unpublished studies.

Selection criteria: Randomised controlled trials (both individual and cluster randomisation) and quasi‐randomised trials, irrespective of language or publication status.

The intervention was micronutrient powders for point‐of‐use fortification of foods, containing at least three micronutrients with one of them being iron, provided to pregnant women of any gestational age and parity. Five comparison groups were considered: no intervention/placebo, iron and folic acid supplements, iron‐only supplements, folic‐acid only supplements, and multiple micronutrients in supplements.

Data collection and analysis: Two review authors independently assessed the eligibility of studies, extracted and checked data accuracy, and assessed the risk of bias of included studies.

Main results: Our search identified 12 reports (relating to six studies). We included two cluster‐randomised controlled trials (involving 1172 women) ‐ these trials were considered to be at a moderate to high risk of bias due to methodological limitations. One trial is ongoing, and three studies were excluded.

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