Abstract
The current study assessed intake of iron-and-folic-acid (IFA) tablet/syrup (grouped into none, < 100 d of IFA consumption or < 100 IFA and ≥ 100 d of IFA consumption or ≥ 100 IFA) among prospective mothers and its association with various stages of low-birth weight (ELBW, extremely low-birth weight; VLBW, very low-birth weight and LBW, low-birth weight) and neonatal mortality (death during day 0-1, 2-6, 7-27 and 0-27) in India. The cross-sectional, nationally representative, 2015-2016 National Family Health Survey (NFHS-4) data were used. Weighted descriptive analysis and multiple binary logistic regression modelling were used. NFHS-4 covered 640 districts from thirty-seven states and union territories of India. A total of 120 374 and 143 675 index children aged 0-59 months were included to analyse LBW and neonatal mortality, respectively. Overall, 30·7 % mothers consumed ≥ 100 IFA in 2015-2016, and this estimate ranged from 0·0 % in Zunheboto district of Nagaland state to 89·5 % in Mahe district of Puducherry of India. Multiple regression analysis revealed that children of mothers who consumed ≥ 100 IFA had lower odds of ELBW, VLBW, LBW and neonatal mortality during day 0-1, as compared with mothers who did not buy/receive any IFA. Consumption of IFA (< 100 IFA and ≥ 100 IFA) had a protective association with neonatal death during day 7-27 and 0-27. Consumption of IFA was not associated with neonatal death during day 2-6. While ≥ 100 IFA consumption during pregnancy was found to be associated with preventing select types of LBW and neonatal mortality, a large variation in coverage of ≥ 100 IFA consumption across 640 districts is concerning.
Highlights
The empirical evidence on the effect of IFA supplementation to pregnant mothers on LBW and survival status of their children in India is at a premature stage. Existing studies on this issue are either outdated[22,23,24] or focus on specific administrative regions of India[10] and small sample studies are prone to low external validity. Against this knowledge gap, using cross-sectional, nationally representative data from India, we assessed whether maternal consumption of IFA during their last pregnancy were associated with selected child health indicators – extremely low-birth weight (ELBW), very low-birth weight (VLBW), low-birth weight (LBW) and neonatal mortality including death during day 0–1, day 2–6 and day 7–27
The current study aimed to understand the coverage of IFA consumption among prospective mothers and to assess the association between IFA consumption and various stages of low-birth weight and neonatal mortality in India
Findings revealed that ≥ 100 IFA consumption by pregnant mothers was associated with reduced odds of ELBW, VLBW, LBW and neonatal death during day 0–1, day 7–27 and day 0–27
Summary
Against this knowledge gap, using cross-sectional, nationally representative data from India, we assessed whether maternal consumption of IFA (categorised into three groups: none, < 100 IFA and ≥ 100 IFA) during their last pregnancy were associated with selected child health indicators – extremely low-birth weight (ELBW), very low-birth weight (VLBW), low-birth weight (LBW) and neonatal mortality (death during days 0–27) including death during day 0–1, day 2–6 and day 7–27. While weighted descriptive analysis was run, unweighted multiple binary logistic regression models[41] were developed to understand the association between the primary variable and various stages of LBW and neonatal mortality.
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