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BackgroundMultiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes.ObjectiveTo conduct a meta-analysis of the effects on stillbirths and on early and late neonatal mortality of supplementation during pregnancy with multiple micronutrients compared with iron-folic acid in recent randomized, controlled trials.MethodsTwelve randomized, controlled trials were included in the analysis (Bangladesh; Burkina Faso; China; Guinea-Bissau; Indramayu and Lombok, Indonesia; Mexico; Sarlahi and Janakur, Nepal; Niger; Pakistan; and Zimbabwe), all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients or iron-folic acid to presumed HIV-negative women.ResultsSupplementation providing approximately I RDA of multiple micronutrients did not decrease the risk of stillbirth (OR = 1.01; 95% CI, 0.88 to 1.16), early neonatal mortality (OR = 1.23; 95% CI, 0.95 to 1.59), late neonatal mortality (OR = 0.94; 95% CI, 0.73 to 1.23), or perinatal mortality (OR = 1.11; 95% CI, 0.93 to 1.33).ConclusionsOur meta-analysis provides consistent evidence that supplementation providing approximately 1 RDA of multiple micronutrients during pregnancy does not result in any reduction in stillbirths or in early or late neonatal deaths compared with iron-folic acid alone.

Original publication




Journal article


Food and nutrition bulletin

Publication Date





S547 - S555


London School of Hygiene and Tropical Medicine, London, UK.


Maternal Micronutrient Supplementation Study Group, Humans, Pregnancy Complications, Iron, Folic Acid, Micronutrients, Pregnancy Outcome, Fetal Mortality, Infant Mortality, Pregnancy, Developing Countries, Dietary Supplements, Infant, Newborn, Female, Stillbirth, Randomized Controlled Trials as Topic, Maternal Nutritional Physiological Phenomena