Multiple-micronutrient supplementation for women during pregnancy

Area of Science:

• Public Health and Epidemiology
• Maternal and Child Health
• Nutritional Science

Background:

• Multiple-micronutrient (MMN) deficiencies are common in women of reproductive age in low- and middle-income countries.
• Pregnancy exacerbates these deficiencies, potentially harming mothers and infants.
• Debate continues on replacing iron and folic acid with MMNs during pregnancy.

Purpose of the Study:

• To evaluate the benefits of oral MMN supplementation during pregnancy.
• To assess effects on maternal, fetal, and infant health outcomes.

Main Methods:

• Systematic review and meta-analysis of prospective randomized controlled trials (RCTs).
• Searched multiple databases including Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, and ICTRP up to February 2018.
• Included 20 RCTs (141,849 women), comparing MMN with iron/folic acid versus iron alone or placebo.

Main Results:

• MMN supplementation significantly reduced low birthweight (LBW) infants (high-quality evidence).
• MMN supplementation probably reduced preterm births and small-for-gestational age (SGA) infants (moderate-quality evidence).
• No significant differences were observed for perinatal, neonatal, or maternal mortality.

Conclusions:

• MMN supplementation with iron and folic acid shows a positive impact on key birth outcomes.
• Findings support considering MMNs as a replacement for iron and folic acid in pregnant women in low- and middle-income countries.
• Further research may be needed to clarify effects on mortality and other outcomes.