SynthesisBulletin of the World Health Organization2011
Maternal multiple micronutrient supplementation and pregnancy outcomes in developing countries: meta-analysis and meta-regression.
Synthesis in Bulletin of the World Health Organization, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 39 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Supplementation With WellnessPack Mama During Pregnancy and Lactation - a Randomized Double-blind, Placebo-controlled Study
Effect of Energy Dense Biscuits in Under Nourished Pregnant Women on Birth Weight of Their Newborns in a Low Income Peri-urban Setting of Karachi; a Community Based Randomized Interventional Study
Who cites it
39 citing papers in PubMed, 11 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH).International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Daily oral iron supplementation during pregnancy.The Cochrane database of systematic reviews · 2024Pooled it
- Pooled it
- Pooled it
- Pooled it
- Multiple-micronutrient supplementation for women during pregnancy.The Cochrane database of systematic reviews · 2019Pooled it
- Multiple-micronutrient supplementation for women during pregnancy.The Cochrane database of systematic reviews · 2017Pooled it
- Maternal antenatal multiple micronutrient supplementation for long-term health benefits in children: a systematic review and meta-analysis.BMC medicine · 2016Pooled it
- Supplementation with multiple micronutrients for breastfeeding women for improving outcomes for the mother and baby.The Cochrane database of systematic reviews · 2016Pooled it
- Multiple-micronutrient supplementation for women during pregnancy.The Cochrane database of systematic reviews · 2015Pooled it
- Micronutrients and pregnancy; effect of supplementation on pregnancy and pregnancy outcomes: a systematic review.Nutrition journal · 2013Pooled it
- Effect of a micronutrient-rich snack taken preconceptionally and throughout pregnancy on ultrasound measures of fetal growth: The Mumbai Maternal Nutrition Project (MMNP).Maternal & child nutrition · 2018Trial
- Trial of ready-to-use supplemental food and corn-soy blend in pregnant Malawian women with moderate malnutrition: a randomized controlled clinical trial.The American journal of clinical nutrition · 2017Trial
- Maternal multivitamin supplementation reduces the risk of diarrhoea among HIV-exposed children through age 5 years.International health · 2014Trial
- Effect of antenatal multiple micronutrient supplementation on anthropometry and blood pressure in mid-childhood in Nepal: follow-up of a double-blind randomised controlled trial.The Lancet. Global health · 2014Trial
- Micronutrient supplementation and pregnancy outcomes: double-blind randomized controlled trial in China.JAMA internal medicine · 2013Trial
- No effect of maternal micronutrient supplementation on early childhood growth in rural western China: 30 month follow-up evaluation of a double blind, cluster randomized controlled trial.European journal of clinical nutrition · 2012Trial
- Ultimate Context of the Termination of Parental Investment.International journal of environmental research and public health · 2025Review
- Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction-A Narrative Review.Nutrients · 2025Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo systematically review randomized controlled trials comparing the effect of supplementation with multiple micronutrients versus iron and folic acid on pregnancy outcomes in developing countries.
methodsMEDLINE and EMBASE were searched. Outcomes of interest were birth weight, low birth weight, small size for gestational age, perinatal mortality and neonatal mortality. Pooled relative risks (RRs) were estimated by random effects models. Sources of heterogeneity were explored through subgroup meta-analyses and meta-regression.
findingsMultiple micronutrient supplementation was more effective than iron and folic acid supplementation at reducing the risk of low birth weight (RR: 0.86, 95% confidence interval, CI: 0.79-0.93) and of small size for gestational age (RR: 0.85; 95% CI: 0.78-0.93). Micronutrient supplementation had no overall effect on perinatal mortality (RR: 1.05; 95% CI: 0.90-1.22), although substantial heterogeneity was evident (I(2) = 58%; P for heterogeneity = 0.008). Subgroup and meta-regression analyses suggested that micronutrient supplementation was associated with a lower risk of perinatal mortality in trials in which > 50% of mothers had formal education (RR: 0.93; 95% CI: 0.82-1.06) or in which supplementation was initiated after a mean of 20 weeks of gestation (RR: 0.88; 95% CI: 0.80-0.97).
conclusionMaternal education or gestational age at initiation of supplementation may have contributed to the observed heterogeneous effects on perinatal mortality. The safety, efficacy and effective delivery of maternal micronutrient supplementation require further research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.