Intergenerational effects of maternal iron supplementation on low birthweight in India

This paper examines the intergenerational effects of maternal micronutrient supplementation with iron and folic acid on the outcome of low birthweight in India.

Using data from the nationally-representative 1998/9 and 2005/6 National Family Health Surveys of India, we assess the population-level effectiveness of iron and folic acid supplementation on low birthweight and birthweight, using multivariable logistic and linear regression models respectively.

We find that only two-thirds of women report taking iron and folic acid supplementation during pregnancy, of whom only one-quarter for the recommended duration. Maternal supplementation is significantly negatively associated with low birthweight, after adjustment for socioeconomic status (OR: 0.77; 95% CI 0.68-0.87), and further adjustment for antenatal care utilization (ANC) (OR: 0.82; 95% CI 0.72-0.94). This corresponded to a 41.28g (95% CI 2.32g-80.2g) increase in birthweight, which attenuated to 27.59g (95% CI -12.4g-67.6g) after adjustment for ANC.

These findings have important implications as India accounts for about 40% of the global burden of low birthweight. Improved implementation of this simple intervention may help reduce intergenerational transmission of poor health status, and reduce India’s burden of low birthweight, and its sequelae.