Maternal deficiency in multiple essential micronutrients is likely to be a major public health problem in low-income countries, and may increase risks of low birth weight and infant morbidity and mortality. There is growing international advocacy from UNICEF and the World Health Organization (WHO) to promote daily multiple micronutrient supplement use for prevention and to improve maternal and infant health; however, the evidence supporting widespread antenatal multiple micronutrient supplement use is currently inconclusive.
Begun in January 2008, the JiVitA-3 trial is currently underway to evaluate the efficacy of a daily maternal multiple micronutrient supplement (with 15 essential vitamins and minerals) given from early pregnancy through 12 weeks postpartum in reducing infant mortality through 6 months of age. The comparison group is composed of infants whose mothers are receiving daily doses of iron and folic acid, the local standard of care. The sample size for this study is 36,000 pregnant women.
Biochemical and Clinical sub-studies Mothers and their infants born into the trial living in a designated “sub-sample area” are enrolled into a more detailed health and nutritional assessment and follow-up protocol. This is to enable investigators to assess specific biochemical and clinical outcomes that may be affected by supplementation and to clarify plausible mechanisms of impact.