Evidence map›Paper›PMID 40752545›Full record

SynthesisAdvances in nutrition (Bethesda, Md.)2025

Effects of vitamin and multiple micronutrient supplementation for pregnant and/or lactating women on maternal and infant nutritional status in low- and middle-income countries: a systematic review and meta-analysis.

Sachin Shinde, Cara A Yelverton, Mashavu Yussuf, Lina Nurhussien, Dongqing Wang, Wafaie W Fawzi

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

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. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sachin ShindeDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America; Center for Inquiry into Mental Health, Pune, India. Electronic address: sshinde@hsph.harvard.edu.
Cara A YelvertonDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Mashavu YussufAfrica Academy for Public Health, Dar Salaam, Tanzania.
Lina NurhussienDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Dongqing WangDepartment of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, United States of America.
Wafaie W FawziDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlobally, over half of women of reproductive age are affected by at least one micronutrient deficiency, often exacerbated during pregnancy and lactation, contributing to adverse maternal and child health outcomes. This systematic review and meta-analysis synthesized impact of vitamin supplementation on maternal, infant and lactational nutritional status in low- and middle-income countries.

methodsMEDLINE, EMBASE, CENTRAL, and WHO library databases were searched. Eligible studies included randomized controlled trials of micronutrient supplementation in healthy pregnant/lactating women, assessing maternal/infant micronutrient status or milk composition. Random-effects meta-analysis was performed for outcomes with ≥2 studies, and evidence quality was evaluated using GRADE.

resultsEighty-seven papers (76 trials, including 65 for meta-analysis) were included. Maternal vitamin B-12 supplementation during pregnancy increased serum cobalamin concentrations (standard mean difference [SMD] 0.39; 95% CI 0.11, 0.68; P=0.01) and reduced deficiency (OR 0.43; 95% CI 0.19, 0.95; P=0.04), with improved B-12 concentrations in milk, especially when administered postpartum (SMD 0.33; 95% CI 0.02, 0.63; P=0.04), but had no consistent effect on infant or cord serum cobalamin concentrations. Vitamin A supplementation during pregnancy or postpartum improved maternal serum concentrations (SMD 0.60; 95% CI 0.13, 1.08; P<0.001) and reduced deficiency at thresholds ≤0.7 μmol/L (OR 0.55; 95% CI 0.43, 0.71; P<0.001); however, its effects on infant and cord serum levels were negligible. Postpartum vitamin A supplementation improved milk vitamin A concentrations (SMD 0.53; 95% CI 0.19, 0.86; P<0.001), particularly with single high-dose regimens. Supplementation with vitamin D during pregnancy increased maternal serum vitamin D concentrations (SMD 1.68; 95% CI 0.99, 2.37; P<0.001), reduced deficiency at thresholds ≤50 nmol/L (OR 0.30; 95% CI 0.14, 0.64; P<0.001) and increased vitamin D concentrations in infant and cord serum.

conclusionsMicronutrient supplementation during pregnancy and lactation improved maternal nutritional status but showed inconsistent effects on infant nutritional status, highlighting the need for further research. PROSPERO REGISTRATION ID: CRD42022308715; https://tinyurl.com/y33cxekr.

Indexed as

Dietary SupplementsInfant Nutritional Physiological PhenomenaLactationMaternal Nutritional Physiological PhenomenaMicronutrientsNutritional StatusVitaminsAdultDeveloping CountriesFemaleHumansInfantInfant, NewbornMilk, HumanPregnancyPregnancy ComplicationsMicronutrientsVitamin B 12Vitaminsantenatal careevidence synthesislow- and middle-income countriesmaternal supplementationmicronutrient deficienciesnutritional statuspostnatal supplementationrandomized controlled trials

Identifiers

PMID40752545
PMCPMC12766057

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Registered trials

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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.