SynthesisAdvances in nutrition (Bethesda, Md.)2025
Contribution of Maternal Adherence to the Effect of Multiple Micronutrient Supplementation During Pregnancy: A Systematic Review and Individual Participant Data Meta-analysis.
Synthesis in Advances in nutrition (Bethesda, Md.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07555093 (A Randomized Controlled Trial in Lombok), which is not on this map. Cited by 14 papers, 2 of them syntheses that pooled it.
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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.
A Randomized Controlled Trial in Lombok: Assessing Factors Influencing Acceptance and Adherence to Multiple Micronutrient Supplementation (MMS) Using Digital Tools
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effective Implementation Strategies for Delivering Nutritional Interventions through the Health System to Prevent Malnutrition during Pregnancy: A Systematic Review and Meta-analysis.Advances in nutrition (Bethesda, Md.) · 2026Pooled it
- Modifiable risk factors for anemia in pregnancy: an umbrella review of systematic reviews and meta-analyses.BMC pregnancy and childbirth · 2025Pooled it
- A Multicountry Analysis of Maternal Selenium Status in Pregnancy and Lactation and Infant Birth Outcomes: Findings from the Women First Maternal Preconception Study.The Journal of nutrition · 2026Trial
- The Impact of Adherence to Prenatal Multiple Micronutrient Supplements on Gestational Weight Gain in Low- and Middle-Income Countries: A Simulation Study.Current developments in nutrition · 2026Article
- Qualitative Evaluation of the Pilot Introduction of Multiple Micronutrient Supplementation in Burkina Faso.Maternal & child nutrition · 2026Article
- Feasibility and Readiness for Scaling-Up Multiple Micronutrient Supplements in Nepal: A Qualitative Study Using the Expandnet Scaling-Up Framework.Maternal & child nutrition · 2026Article
- Costs and benefits of replacing preventive antenatal iron and folic acid with multiple micronutrients in 25 low- and middle-income countries.BMJ global health · 2026Article
- Article
- A to Z of Health: An Evidence-Based Narrative Review of Multivitamin-Multimineral and Nutraceutical Supplementation.Cureus · 2026Review
- Acceptability, Adherence, and Provision Through Antenatal Care: Evidence on Multiple Micronutrient Supplementation in Pakistan and Nigeria.Nutrients · 2026Article
- Article
- Article
- Maternal nutrition literacy and associated factors as determinant of micronutrient supplementation adherence among Chinese pregnant women: a multi-center cross-sectional study.Frontiers in nutrition · 2026Article
- Validation Study of Adherence to Daily Multiple Micronutrient Supplementation by Palestine Refugee Women Attending United nations Relief and Works Agency for Palestine Refugees in the Near East Health Clinics in Jordan.Current developments in nutrition · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
37 authors.
Funding
Abstract
Multiple micronutrient supplements (MMS) in pregnancy reduces risk of infant low birthweight (LBW) and improves other maternal and infant outcomes compared with iron and folic acid (IFA) supplements alone. However, the impact of timing of initiation and adherence on the MMS effectiveness in real-world programs remains unclear. To address this, we conducted a 2-stage individual participant data meta-analysis that included 15 randomized trials (61,204 pregnant women) and assessed whether the relative effect of MMS differed by the following: adherence alone; adherence in combination with gestational age at initiation; and the total number of tablets taken. We also evaluated the observational association of these factors with outcomes among participants who received MMS. Compared with IFA supplements, the relative effect of MMS on the primary outcome of continuous birthweight was greater with higher adherence (P-interaction < 0.05). Among women who took ≥90% of supplements, MMS increased birthweight by 56 g (95% CI: 45, 67 g), whereas among women who took <60% of supplements, there was no difference in birthweight between MMS and IFA supplements [mean difference (MD): 9 g; 95% CI: -17, 35 g). Higher adherence was also associated with greater effect of MMS on LBW and birthweight-for-gestational age centile and women who took more supplements experienced a greater relative impact of MMS on birthweight-for-gestational age centile and small-for-gestational age births (SGA) as compared with IFA supplements. Observational analyses among participants who received MMS showed that ≥90% adherence was associated with increased birthweight (MD: 44 g; 95% CI: 31, 56 g) and lower risk of LBW [relative risk (RR): 0.93 g; 95% CI: 0.88, 0.98 g] and small-for-gestational age (RR: 0.95; 95% CI: 0.93, 0.98), whereas <75% adherence was associated with greater risk of stillbirth (RR: 1.43; 95% CI: 1.12, 1.83) and maternal anemia (RR: 1.26; 95% CI: 1.11, 1.43) than 75%-90% adherence. Programs should invest in strategies that promote early initiation and high adherence to MMS. This trial was registered at PROSPERO as CRD42022319207.
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