Dose-response relationship between IFA supplementation during pregnancy with post-partum anaemia of woman, low birth weight and neonatal mortality of infant: Evidence from India

In India, iron deficiency anaemia remained an intractable problem despite national policies recommending routine iron-folate (IFA) and food supplementation. Poor effectiveness of IFA supplementation has been attributed to various factors including: Insufficient dose, Time of supplementation and Poor adherence. Understanding dose-response relationships between IFA and food supplementations during pregnancy with: severe/moderate and overall anameia in post-partum women and low birth weight (LBW) and neonatal mortality among infants - could help optimize implementation of anaemia control policies. We undertook an analysis of three large cross-sectional surveys in India during 2005-09, to test the hypothesis whether, ‘higher doses of IFA consumption during pregnancy improve post-partum haemoglobin (Hb), decrease severe/moderate and overall anaemia, decrease LBW, and decrease neonatal mortality or not. Our analysis showed, increase in IFA-dose during pregnancy resulted in corresponding increase in mean Hb level, significant drop in severe/moderate and overall anaemia, and significant drop in incidence of neonatal deaths, even after adjusting for socio-demographic factors. IFA supplementation increased the risk of LBW, although association was insignificant. Associations between exclusive food supplementation and outcomes were in expe