Objectives
The primary objective was to compare the effect of twice weekly
antenatal provision of (1) IFA supplementation or (2) MMN
supplementation with daily provision of antenatal IFA supplementation,
on maternal and infant outcomes.
Outcomes
The primary outcome was infant birth weight. Secondary
outcomes were maternal hemoglobin and ferritin at 32 wk, and
infant length-for-age z-scores, hemoglobin, ferritin, and cognitive
development at 6 mo of age. All interventions were delivered at
the level of the commune, and outcomes were measured at the
individual level as follows.
Birth outcome measures. Gestational age at birth was
calculated from estimated gestational age recorded by transabdominal
ultrasound performed at the district hospital if available
(1,041 infants), and if not, according to the date of last
menstruation (136 infants). Stillbirths (fetal deaths at or after
28 wk of pregnancy) and early neonatal deaths (defined here as
deaths within the first 24 h after birth) were documented by
trained commune health station midwives.
Anthropometric measures. Research staff recorded triplicate
measurements of anthropometric measures, a second observer
checked all measurements, and the median measurement was used
for analysis. Digital infant weighing scales with precision to the
nearest 10 g (BF20510, Laica) were provided for birth weight
measurements in each commune health station and district
hospital. For home deliveries, commune and village health workers
assessed the woman and baby within 72 h of birth. Maternal
height, birth crown–heel length, and infant crown–heel length
were measured using a portable Shorr Board (Shorr Productions).
Head circumference was measured using a non-stretchable
measuring tape. Maternal weight and infant weight at 6 mo were