Background: Neonatal mortality is the biggest contributor to global mortality of children younger than 5 years, and low birthweight is a crucial underlying factor. We tested the hypotheses that antenatal multiple micr...Background: Neonatal mortality is the biggest contributor to global mortality of children younger than 5 years, and low birthweight is a crucial underlying factor. We tested the hypotheses that antenatal multiple micronutrient supplementation would increase infant birthweight and gestational duration. Methods: We did a doubleblind, randomised controlled trial in Dhanusha district, Nepal. Women attending for antenatal care with singleton pregnancies at up to 20 weeks’ gestation were invited to participate. Participants were randomly allocated either routine iron and folic acid supplements (control; n=600) or a multiple micronutrient supplement providing a recommended daily allowance of 15 vitamins and minerals (intervention; n=600). Supplementation began at a minimum of 12 weeks’ gestation and continued until delivery. Primary outcome measures were birthweight and gestational duration. Analysis was by intention to treat. The study is registered as an International Standard Randomised Controlled Trial, number ISRCTN88625934. Findings: Birthweight was available for 523/600 infants in the control group and 529/600 in the intervention group. Mean birthweight was 2733 g (SD 422) in the control group and 2810 g (453) in the intervention group, representing a mean difference of 77 g (95% CI 24-130; p=0.004) and a relative fall in the proportion of low birthweight by 25% . No difference was recorded in the duration of gestation (0.2 weeks -0.1 to 0.4 ; p=0.12), infant length (0.3 cm -0.1 to 0.6 ; p=0.16), or head circumference (0.2 cm -0.1 to 0.4 ; p=0.18). Interpretation: In a poor community in Nepal, consumption of a daily supplement containing a recommended daily allowance of 15 micronutrients in the second and third trimesters of pregnancy was associated with increased birthweight when compared with a standard iron and folic acid preparation. The effects on perinatal morbidity and mortality need further comparisons between studies.展开更多
文摘目的:探讨脑电同步化磁震荡治疗(Neuro-EEG Synchronization Therapy,NEST)对药物疗效不佳的抑郁症患者治疗的疗效和安全性。方法:本研究采用两中心的前瞻性随机双盲对照设计。62例符合DSM-IV重性抑郁障碍诊断标准的患者经系统药物治疗后,疗效不佳的抑郁患者按2∶1随机分入试验组或安慰对照组,疗程为4周,治疗20次,30min/次。于基线和治疗后第1、2、3、4周末,以汉密尔顿抑郁量表(Hamilton Rating Scale for Depression,HAMD)、临床总体印象量表(Clinical Global Impression,CGI)和自编副作用检查表对患者实施双盲法疗效和安全性评定。结果:试验组有36例患者完成了本试验,对照组有21例完成了本试验。试验组有效率高于对照组(44.44%vs.9.52%,P=0.006)。重复测量方差分析显示,试验组的HAMD评分(F=4.868,P=0.032)和CGI-S评分优于对照组(F=5.169,P=0.023)。试验组与对照组副作用发生率差异无统计学意义(4/36vs.1/21,P=0.642)。结论:脑电同步化磁震荡治疗抑郁症有一定疗效并较为安全可靠,值得进一步探讨。
文摘Background: Neonatal mortality is the biggest contributor to global mortality of children younger than 5 years, and low birthweight is a crucial underlying factor. We tested the hypotheses that antenatal multiple micronutrient supplementation would increase infant birthweight and gestational duration. Methods: We did a doubleblind, randomised controlled trial in Dhanusha district, Nepal. Women attending for antenatal care with singleton pregnancies at up to 20 weeks’ gestation were invited to participate. Participants were randomly allocated either routine iron and folic acid supplements (control; n=600) or a multiple micronutrient supplement providing a recommended daily allowance of 15 vitamins and minerals (intervention; n=600). Supplementation began at a minimum of 12 weeks’ gestation and continued until delivery. Primary outcome measures were birthweight and gestational duration. Analysis was by intention to treat. The study is registered as an International Standard Randomised Controlled Trial, number ISRCTN88625934. Findings: Birthweight was available for 523/600 infants in the control group and 529/600 in the intervention group. Mean birthweight was 2733 g (SD 422) in the control group and 2810 g (453) in the intervention group, representing a mean difference of 77 g (95% CI 24-130; p=0.004) and a relative fall in the proportion of low birthweight by 25% . No difference was recorded in the duration of gestation (0.2 weeks -0.1 to 0.4 ; p=0.12), infant length (0.3 cm -0.1 to 0.6 ; p=0.16), or head circumference (0.2 cm -0.1 to 0.4 ; p=0.18). Interpretation: In a poor community in Nepal, consumption of a daily supplement containing a recommended daily allowance of 15 micronutrients in the second and third trimesters of pregnancy was associated with increased birthweight when compared with a standard iron and folic acid preparation. The effects on perinatal morbidity and mortality need further comparisons between studies.
