Abstract

receipt, with or without added iron orzinc.The two trials in southern Nepal sug-gest that neonatal mortality rose afterdaily use of an antenatal micronutrientsupplement that also increased birth-weight. Although chance couldexplain this effect, the statisticalstrength obtained from our pooledanalysis suggests that this is a lesslikely explanation than other sus-pected or unknown mechanisms, atleast in this rural south Asian setting.As we emphasised earlier, it ispresently inappropriate to extrapolatethese findings to other populations.However, our findings do support anemerging concept that antenatal sup-plements might need to be formu-lated to optimise benefit and minimiserisk on a broad, regional basis, takinginto consideration general profiles ofnutritional status, size, and diseaseburden. Assessment of the full public-health effect of antenatal micronutri-ent supplementation in malnourishedpopulations represents an urgentresearch priority.

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