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Multiple-micronutrient supplementation for women during pregnancy

  1. Batool A Haider1,
  2. Zulfiqar A Bhutta2,*

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 14 NOV 2012

Assessed as up-to-date: 17 FEB 2012

DOI: 10.1002/14651858.CD004905.pub3


How to Cite

Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD004905. DOI: 10.1002/14651858.CD004905.pub3.

Author Information

  1. 1

    Harvard School of Public Health, Departments of Epidemiology and Nutrition, Boston, MA, USA

  2. 2

    Aga Khan University Hospital, Division of Women and Child Health, Karachi, Pakistan

*Zulfiqar A Bhutta, Division of Women and Child Health, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan. zulfiqar.bhutta@aku.edu.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 14 NOV 2012

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This is not the most recent version of the article. View current version (01 NOV 2015)

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Bhutta 2009a {unpublished data only}
  • Bhutta ZA, Rizvi A, Raza F, Hotwani S, Zaidi S, Soofi S, et al. A comparative evaluation of multiple micronutrient and iron-folate supplementation during pregnancy in Pakistan: impact on pregnancy outcomes. Food and Nutrition Bulletin 2009;30(4):S496-S505.
  • Persson LA, Eneroth H, Ekstrom EC. Multiple micronutrient supplementation during pregnancy: a review of effects on birth size, maternal haemoglobin and perinatal mortality demonstrated in trials in Bangladesh, Guinea-Bissau and Pakistan. Report for UNICEF/UNU/WHO 2004.
Brough 2010 {published data only}
  • Brough L, Rees GA, Crawford MA, Morton RH, Dorman EK. Effect of multiple-micronutrient supplementation on maternal nutrient status, infant birth weight and gestational age at birth in a low-income, multi-ethnic population. British Journal of Nutrition 2010;104(3):437-45.
Christian 2003 {published data only}
  • Christian P, Darmstadt GL, Wu L, Khatry SK, LeClerq SC, Katz J, et al. The effect of maternal micronutrient supplementation on early neonatal morbidity in rural Nepal: a randomised, controlled, community trial. Archives of Disease in Childhood 2008;93(8):660-4.
  • Christian P, Jiang T, Khatry SK, LeClerq SC, Shrestha SR, West Jr KP. Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal. American Journal of Clinical Nutrition 2006;83:788-94.
  • Christian P, Khatry SK, Katz J, Pradhan EK, LeClerq SC, Shrestha SR, et al. Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial. BMJ 2003;326:571.
  • Christian P, Khatry SK, LeClerq SC, Dali SM. Effects of prenatal micronutrient supplementation on complications of labor and delivery and puerperal morbidity in rural Nepal. International Journal of Gynaecology and Obstetrics 2009;106(1):3-7.
  • Christian P, Murray-Kolb LE, Khatry SK, Katz J, Schaefer BA, Cole PM, et al. Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal. JAMA 2010;304(24):2716-23.
  • Christian P, Shrestha J, LeClerq SC, Khatry SK, Jiang T, Wagner T, et al. Supplementation with micronutrients in addition to iron and folic acid does not further improve the hematologic status of pregnant women in rural Nepal. Journal of Nutrition 2003;133:3492-8.
  • Christian P, Stewart CP, LeClerq SC, Wu L, Katz J, West KP Jr, et al. Antenatal and postnatal iron supplementation and childhood mortality in rural Nepal: a prospective follow-up in a randomized, controlled community trial. American Journal of Epidemiology 2009;170(9):1127-36.
  • Christian P, West KP Jr, Khatry SK, LeClerq SC, Pradhan EK, Katz J, et al. Effects of maternal micronutrient supplementation on fetal loss and infant mortality: a cluster-randomised trial in Nepal. American Journal of Clinical Nutrition 2003;78:1194-202.
  • Katz J, Christian P, Dominici F, Zeger SL. Treatment effects of maternal micronutrient supplementation vary by percentiles of the birth weight distribution in rural Nepal. Journal of Nutrition 2006;136:1389-94.
  • Kulkarni B, Christian P, LeClerq SC, Khatry SK. Determinants of compliance to antenatal micronutrient supplementation and women's perceptions of supplement use in rural Nepal. Public Health Nutrition 2010;13(1):82-90.
  • Stewart CP, Christian P, LeClerq SC, West KP Jr, Khatry SK. Antenatal supplementation with folic acid + iron + zinc improves linear growth and reduces peripheral adiposity in school-age children in rural Nepal. American Journal of Clinical Nutrition 2009;90(1):132-40.
  • Stewart CP, Christian P, Schulze KJ, Arguello M, Leclerq SC, Khatry SK, et al. Low maternal vitamin B-12 status is associated with offspring insulin resistance regardless of antenatal micronutrient supplementation in rural Nepal. Journal of Nutrition 2011;141(10):1912-7.
  • Stewart CP, Christian P, Schulze KJ, Leclerq SC, West KP Jr, Khatry SK. Antenatal micronutrient supplementation reduces metabolic syndrome in 6- to 8-year-old children in rural Nepal. Journal of Nutrition 2009;139(8):1575-81.
Dieckmann 1943 {published data only}
  • Dieckmann WJ, Adair FL, Michel H, Kramer S, Dunkle F, Arthur B, et al. Calcium, phosphorus, iron and nitrogen balances in pregnant women. American Journal of Obstetrics and Gynecology 1943;47:357-68.
Fawzi 2007 {published data only}
  • Fawzi WW, Msamanga GI, Urassa W, Hertzmark E, Petraro P, Willett WC, et al. Vitamins and perinatal outcomes among HIV-negative women in Tanzania. New England Journal of Medicine 2007;356(14):1423-31.
Friis 2004 {published data only}
  • Friis H, Gomo E, Nyazema N, Ndhlovu P, Krarup H, Kaestel P, et al. Effect of micronutrient supplementation on gestational length and birth size: a randomized, placebo-controlled, double-blind effectiveness trial in Zimbabwe. American Journal of Clinical Nutrition 2004;80:178-84.
Gupta 2007 {published data only}
  • Gupta P, Ray M, Dua T, Radhakrishnan G, Kumar R, Sachdev HP. Multimicronutrient supplementation for undernourished pregnant women and the birth size of their offspring: a double-blind, randomized, placebo-controlled trial. Archives of Pediatrics and Adolescent Medicine 2007;161(1):58-64.
Hininger 2004 {published data only}
  • Hininger I, Favier M, Arnaud J, Faure H, Thoulon JM, Hariveau E, et al. Beneficial effects of a combined micronutrient supplementation on maternal oxidative stress and newborn anthropometric measurements: a randomised double blind, placebo-controlled trial in healthy pregnant women. 21st Conference on Priorities in Perinatal Care in South Africa; 2002 March 5-8; Eastern Cape, South Africa. 2002.
  • Hininger I, Favier M, Arnaud J, Faure H, Thoulon JM, Hariveau E, et al. Effects of a combined micronutrient supplementation on maternal biological status and newborn anthropometric measurements: a randomized double-blind, placebo-controlled trial in apparently healthy pregnant women. European Journal of Clinical Nutrition 2004;58:52-9.
Jarvenpaa 2007 {published data only}
  • Jarvenpaa J, Schwab U, Lappalainen T, Pakkila M, Niskanen L, Punnonen K, et al. Fortified mineral water improves folate status and decreases plasma homocysteine concentration in pregnant women. Journal of Perinatal Medicine 2007;35(2):108-14.
  • Jarvenpaa J, Schwab U, Lappalainen T, Pakkila M, Niskanen L, Punnonen K, et al. Mineral water fortified with folic acid and vitamins B6, B12, D and calcium improves folate status and decreases plasma homocysteine concentration in pregnant women. 35th Nordic Congress of Obstetrics and Gynecology; 2006 May 23-25; Goteburg, Sweden. 2008:55.
Kaestel 2005 {published data only}
  • Andersen GS, Friis H, Michaelsen KF, Rodrigues A, Benn CS, Aaby P, et al. Effects of maternal micronutrient supplementation on fetal loss and under-2-years child mortality: long-term follow-up of a randomised controlled trial from Guinea-Bissau. African Journal of Reproductive Health 2010;14(2):17-26.
  • Kaestel P, Michaelsen KF, Aaby P, Friis H. Effects of prenatal multimicronutrient supplements on birth weight and perinatal mortality: a randomised, controlled trial in Guinea-Bissau. European Journal of Clinical Nutrition 2005;59(9):1081-9.
Osrin 2005 {published data only}
  • Hindle LJ, Gitau R, Filteau SM, Newens KJ, Osrin D, Costello AM, et al. Effect of multiple micronutrient supplementation during pregnancy on inflammatory markers in Nepalese women. American Journal of Clinical Nutrition 2006;84:1086-92.
  • MIRA (Mother Infant Research Unit). MIRA Janakpur. Multiple micronutrient supplementation study. The effects of multiple micronutrient supplementation on birthweight, gestation and infection: a double blind, randomised controlled trial conducted in Nepal. Personal communication 2003:1-18.
  • Osrin D, Vaidya A, Shrestha Y, Baniya RB, Manandhar DS, Adhikari RK, et al. Effects of antenatal micronutrient supplementation on birthweight and gestational duration in Nepal: double-blind, randomised controlled trial. Lancet 2005;365:955-62.
  • Vaidya A, Saville N, Shrestha BP, Costello AM, Manandhar DS, Osrin D. Effects of antenatal multiple micronutrient supplementation on children's weight and size at 2 years of age in Nepal: follow-up of a double-blind randomised controlled trial. Lancet 2008;371(9611):492-9.
Ramakrishnan 2003 {published data only}
  • de Lourdes Flores M, Neufeld LM, Gonzalez-Cossio T, Rivera J, Martorell R, Ramakrishnan U. Multiple micronutrient supplementation and dietary energy intake in pregnant women. Salud Publica de Mexico 2007;49(3):190-8.
  • Garcia-Guerra A, Neufeld LM, Hernandez-Cordero S, Rivera J, Martorell R, Ramakrishnan U. Prenatal multiple micronutrient supplementation impact on biochemical indicators during pregnancy and postpartum. Salud Publica de Mexico 2009;51(4):327-35.
  • Ramakrishnan U, Cossio TG, Neufeld LM, Rivera J, Martorell R. Effect of prenatal multiple micronutrient supplements on maternal weight and skinfold changes: A randomized double-blind clinical trial in Mexico. Food and Nutrition Bulletin 2005;26(3):273-80.
  • Ramakrishnan U, Gonzalez-Cossio T, Neufeld LM, Rivera J, Martorell R. Multiple micronutrient supplementation during pregnancy does not lead to greater infant birth size than does iron-only supplementation: a randomized controlled trial in a semirural community in Mexico. American Journal of Clinical Nutrition 2003;77:720-5.
  • Ramakrishnan U, Neufeld LM, Gonzalez-Cossio T, Villalpando S, Garcia-Guerrra A, Juan R, et al. Multiple micronutrient supplements during pregnancy do not reduce anemia or improve iron status compared to iron-only supplements in semirural Mexico. Journal of Nutrition 2004;134:898-903.
Roberfroid 2008 {published data only}
  • Roberfroid D, Huybregts L, Habicht JP, Lanou H, Henry MC, Meda N, et al. Randomized controlled trial of 2 prenatal iron supplements: is there a dose-response relation with maternal hemoglobin?. American Journal of Clinical Nutrition 2011;93:1012-8.
  • Roberfroid D, Huybregts L, Lanou H, Henry MC, Meda N, Kolsteren F P, et al. Effect of maternal multiple micronutrient supplements on cord blood hormones: a randomized controlled trial. American Journal of Clinical Nutrition 2010;91(6):1649-58.
  • Roberfroid D, Huybregts L, Lanou H, Henry MC, Meda N, Menten J, et al. Effects of maternal multiple micronutrient supplementation on fetal growth: a double-blind randomized controlled trial in rural Burkina Faso. American Journal of Clinical Nutrition 2008;88:1330-40.
Rumiris 2006 {published data only}
  • Rumiris D, Purwosunu Y, Wibowo N, Farina A, Sekizawa A. Lower rate of preeclampsia after antioxidant supplementation in pregnant women with low antioxidant status. Hypertension in Pregnancy 2006;25:241-53.
Sood 1975 {published data only}
  • Sood SK, Ramachandran K, Mathur M, Gupta K, Ramalingaswami V, Swarnbai C, et al. WHO sponsored collaborative study on nutritional anemia in India. Quarterly Journal of Medicine, New Series XLIV 1975;174:241-58.
SUMMIT 2008 {published data only}
  • Sebayang SK, Dibley MJ, Kelly P, Shankar AV, Shankar AH. Modifying effect of maternal nutritional status on the impact of maternal multiple micronutrient supplementation on birthweight in Indonesia. European Journal of Clinical Nutrition 2011;65(10):1110-7.
  • Shankar AV, Asrilla Z, Kadha JK, Sebayang S, Apriatni M, Sulastri A, et al. Programmatic effects of a large-scale multiple-micronutrient supplementation trial in Indonesia: using community facilitators as intermediaries for behavior change. Food and Nutrition Bulletin 2009;30(2 Suppl):S207-14.
  • The Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT) Study Group, Shankar AH, Jahari AB, Sebayang SK, Aditiawarman, Apriatni M, et al. Effect of maternal multiple micronutrient supplementation on fetal loss and infant death in Indonesia: a double-blind cluster-randomised trial. Lancet 2008;371(9608):215-27.
Sunawang 2009 {published data only}
  • Sunawang, Utomo B, Hidayat A, Kusharisupeni, Subarkah. Preventing low birth weight through maternal multiple micronutrient supplementation: a cluster-randomized controlled trial in Indramayu, West Java. Food and Nutrition Bulletin 2009;30(4):S488-S495.
Tatala 2002 {published data only}
  • Makola D, Ask DM, Tatala SR, Latham MC, Ndossi G, Mehansho H. A micronutrient-fortified beverage prevents iron deficiency, reduces anemia and improves the hemoglobin concentration in pregnant Tanzanian women. Journal of Nutrition 2003;133:1339-46.
  • Tatala SR, Ash D, Makola D, Latham M, Ndosi G, Grohn Y. Effect of micronutrient fortified beverage on nutritional anaemia during pregnancy. East African Medical Journal 2002;79(11):598-603.
Theobald 1937 {published data only}
  • Theobald GW, Camb MD. Effect of calcium and vitamins A and D on incidence of pregnancy toxaemia. Lancet 1937;2:1397-9.
Tofail 2008 {published and unpublished data}
  • Eneroth H, El Arifeen S, Persson LA, Lonnerdal B, Hossain MB, Stephensen CB, et al. Maternal multiple micronutrient supplementation has limited impact on micronutrient status of Bangladeshi infants compared with standard iron and folic acid supplementation. Journal of Nutrition 2010;140(3):618-24.
  • Eneroth H, Persson LA, El Arifeen S, Ekstrom EC. Infant anaemia is associated with infection, low birthweight and iron deficiency in rural Bangladesh. Acta Paediatrica 2011;100(2):220-5.
  • Persson LA, Eneroth H, Ekstrom EC. Multiple Micronutrient supplementation during pregnancy: A review of effects on birth size, maternal haemoglobin and perinatal mortality demonstrated in trials in Bangladesh, Guinea-Bissau and Pakistan. Report for UNICEF/UNU/WHO 2004.
  • Tofail F, Persson LA, Arifeen SE, Hamadani JD, Mehrin F, Ridout D, et al. Effects of prenatal food and micronutrient supplementation on infant development: a randomized trial from maternal and infant nutrition intervention, Matlab (MINIMat) study. American Journal of Clinical Nutrition 2008;87:704-11.
Vadillo-Ortega 2011 {published data only}
  • Vadillo-Ortega F, Perichart-Perera O, Espino S, Avila-Vergara MA, Ibarra I, Ahued R, et al. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial. BMJ 2011;342:d2901.
Zagre 2007 {published data only}
  • Zagre NM, Desplats G, Adou P, Mamadoultaibou A, Aguayo VM. Prenatal multiple micronutrient supplementation has greater impact on birthweight than supplementation with iron and folic acid: a cluster-randomized, double-blind, controlled programmatic study in rural Niger. Food and Nutrition Bulletin 2007;28(3):317-27.
Zeng 2008 {published data only}
  • Li Q, Yan H, Zeng L, Cheng Y, Liang W, Dang S, et al. Effects of maternal multimicronutrient supplementation on the mental development of infants in rural western China: follow-up evaluation of a double-blind, randomized, controlled trial. Pediatrics 2009;123(4):e685-e692.
  • Yan H. Impact of iron/folate versus multi-micronutrient supplementation during pregnancy on birth weight: a randomised controlled trial in rural Western China. Current Controlled Trials (www.controlled-trials.com) (accessed 15 February 2007).
  • Zeng L, Cheng Y, Dang S, Yan H, Dibley MJ, Chang S, et al. Impact of micronutrient supplementation during pregnancy on birth weight, duration of gestation and perinatal mortality in rural western China: double blind cluster randomised controlled trial. BMJ 2008;337:a2001.
  • Zeng L, Yan H, Cheng Y, Dang S, Dibley MJ. Adherence and costs of micronutrient supplementation in pregnancy in a double-blind, randomized, controlled trial in rural western China. Food and Nutrition Bulletin 2009;30(4):S480-7.
  • Zeng L, Yan H, Cheng Y, Dibley MJ. Modifying effects of wealth on the response to nutrient supplementation in pregnancy on birth weight, duration of gestation and perinatal mortality in rural western China: double-blind cluster randomized controlled trial. International Journal of Epidemiology 2011;40(2):350-62.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Aguayo 2005 {published data only}
  • Aguayo VM, Kone D, Bamba SI, Diallo B, Sidibe Y, Traore D, et al. Acceptability of multiple micronutrient supplements by pregnant and lactating women in Mali. Public Health Nutrition 2005;8(1):33-7.
Ahn 2006 {published data only}
  • Ahn E, Pairaudeau N, Pairaudeau N, Cerat Y, Couturier B, Fortier A, et al. A randomized cross over trial of tolerability and compliance of a micronutrient supplement with low iron separated from calcium vs high iron combined with calcium in pregnant women. BMC Pregnancy and Childbirth 2006;6:10.
An 2001 {published data only}
  • An H, Yin S, Xu Q. Effects of supplementing calcium, iron and zinc on the fetus development and growth during pregnancy. Chinese Journal of Preventive Medicine 2001;35(6):370-3.
Arsenault 2010 {published data only}
  • Arsenault JE, Aboud S, Manji KP, Fawzi WW, Villamor E. Vitamin supplementation increases risk of subclinical mastitis in HIV-infected women. Journal of Nutrition 2010;140(10):1788-92.
Beazley 2002 {published data only}
  • Beazley D, Ahokas R, Livingston J, Griggs M, Scroggs M, Sibai B. Effects of vitamin C and E supplementation on total antioxidant status (tas) and 8-isoprostane (ip) levels in women at high risk for preeclampsia. American Journal of Obstetrics and Gynecology 2002;187(6 Pt 2):S76.
  • Beazley D, Livingston J, Kao L, Sibai L. Vitamin C and E supplementation in women at high risk for preeclampsia: a double-blind placebo controlled trial. American Journal of Obstetrics and Gynecology 2002;187(6 Pt 2):S216.
Bergmann 2006 {published data only}
  • Bergmann RL, Haschke-Becher, Bergmann KE, Dudenhausen JW, Haschke F. Low dose docosahexaenoic acid supplementation improves the DHA status of pregnant women. Pediatric Academic Societies Annual Meeting; 2006 April 29-May 2; San Francisco, CA, USA. 2006.
Biswas 1984 {published data only}
  • Biswas MK, Pernoll MJ, Mabie WC. A placebo controlled comparative trial of various prenatal vitamin formulations in pregnant women. Clinical Therapeutics 1984;6(6):763-9.
Carrasco 1962 {published data only}
  • Carrasco EO, Jose FR, Samson GD, Germar E, Padilla B. Effect of D-sorbitol on the absorption and transfer of nutrients from mother to fetus. American Journal of Clinical Nutrition 1962;11:533-6.
Caulfield 1999 {published data only}
  • Caulfield LE, Zavaleta N, Figueroa A, Leon Z. Maternal zinc supplementation does not affect size at birth or pregnancy duration in Peru. Journal of Nutrition 1999;129(8):1563-8.
Caulfield 1999a {published data only}
  • Caulfield LE Zavaleta N, Figueroa A. Adding zinc to prenatal iron and folate supplements improves maternal and neonatal zinc status in a Peruvian population. American Journal of Clinical Nutrition 1999;69:1257-63.
Chames 2002 {published data only}
  • Chames M, Liu H, Bendich A, Bogden J, Sibai B, Prada J. A randomized trial of calcium supplementation effects on blood lead levels in pregnancy. American Journal of Obstetrics and Gynecology 2002;187(6 Pt 2):S137.
Christian 2009 {published data only}
  • Bhutta Z. Severe anemia treatment trials, Pakistan (ongoing trial). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 21 March 2006) 2006.
  • Christian P, Shahid F, Rizvi A, Klemm RDW, Bhutta ZA. Treatment response to standard of care for severe anemia in pregnant women and effect of multivitamins and enhanced anthelminthics. American Journal of Clinical Nutrition 2009;89:853-61.
Czeizel 1996 {published data only}
Dawson 1987 {published data only}
Dawson 1998 {published data only}
  • Dawson EB, Dawson R, Behrens J, DeVora M, McGanity WJ. Iron in prenatal multivitamin/multimineral supplements. Journal of Reproductive Medicine 1998;43:133-40.
Fawzi 1998 {published data only}
  • Fawzi W, Msamanga G, Antelman G, Xu C, Hertzmark E, Spiegelman D, et al. Effect of prenatal vitamin supplementation on lower genital levels of HIV type 1 and interleukin type 1 beta at 36 weeks of gestation. Clinical Infectious Diseases 2004;38(5):716-22.
  • Fawzi WW, Msamanga G, Hunter D, Urassa E, Renjifo B, Mwakagile D, et al. Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania. Journal of Acquired Immune Deficiency Syndromes 2000;23(3):246-54.
  • Fawzi WW, Msamanga G, Spiegelman D, Wei R, Kapiga S, Villamor E, et al. A randomised trial of multivitamin supplements and HIV disease progression and mortality. New England Journal of Medicine 2004;351(1):23-32.
  • Fawzi WW, Msamanga GI, Kupka R, Spiegelman D, Villamor E, Mugusi F, et al. Multivitamin supplementation improves hematologic status in HIV-infected women and their children in Tanzania. American Journal of Clinical Nutrition 2007;85(5):1335-43.
  • Fawzi WW, Msamanga GI, Spiegelman D, Urassa EJN, McGarth N, Mwakagile D, et al. Randomized controlled trial of the effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV -1 infected women in Tanzania. Lancet 1998;351:1477-82.
  • Kawai K, Kupka R, Mugusi F, Aboud S, Okuma J, Villamor E, et al. A randomized trial to determine the optimal dosage of multivitamin supplements to reduce adverse pregnancy outcomes among HIV-infected women in Tanzania. American Journal of Clinical Nutrition 2010;91(2):391-7.
  • Kawai K, Msamanga G, Manji K, Villamor E, Bosch RJ, Hertzmark E, et al. Sex differences in the effects of maternal vitamin supplements on mortality and morbidity among children born to HIV-infected women in Tanzania. British Journal of Nutrition 2010;103(12):1784-91.
  • Villamor E, Koulinska IN, Aboud S, Murrin C, Bosch RJ, Manji KP, et al. Effect of vitamin supplements on HIV shedding in breast milk. American Journal of Clinical Nutrition 2010;92(4):881-6.
  • Villamor E, Msamanga G, Saathoff E, Manji K, Fawzi WW. Effect of vitamin supplements on the incidence of malaria among children born to HIV-infected Women. FASEB Journal 2006;20(4 Pt 1):A125.
  • Villamor E, Msamanga G, Spiegelman D, Antelman G, Peterson KE, Hunter DJ, et al. Effect of multivitamin and vitamin A supplements on weight gain during pregnancy among HIV-1 infected women. American Journal of Clinical Nutrition 2002;76:1082-90.
  • Villamor E, Saathoff E, Bosch RJ, Hertzmark E, Baylin A, Manji K, et al. Vitamin supplementation of HIV-infected women improves postnatal child growth. American Journal of Clinial Nutrition 2005;81(4):880-8.
Feyi-Waboso 2005 {published data only}
  • Feyi-Waboso PA, Chris A, Nwaogu GC, Archibong EI, Ejikem EC. The role of parenteral multivitamin preparation (Eldervit-12) in the prevention of anaemia in pregnancy. Tropical Journal of Obstetrics and Gynaecology 2005;22(2):159-63.
Fleming 1986 {published data only}
  • Fleming AF, Ghatoura GBS, Harrison KA, Briggs ND, Dunn DT. The prevention of anemia in pregnancy in primigravidae in the Guinea Savana of Nigeria. Annals of Tropical Medicine and Parasitology 1986;80(2):211-33.
Goldenberg 1995 {published data only}
  • Goldenberg R, Tamura T, Neggers Y, Copper R, Johnston K, DuBard M, et al. Maternal zinc supplementation increases birthweight and head circumference. American Journal of Obstetrics and Gynecology 1995;172(1 Pt 2):368.
Gopalan 2004 {published data only}
  • Gopalan S, Patnaik R, Ganesh K. Feasible strategies to combat low birth weight and intra-uterine growth retardation. Journal of Pediatric Gastroenterology and Nutrition 2004;39 Suppl 1:S37.
Graham 2007 {published data only}
  • Graham JM, Haskell MJ, Pandey P, Shrestha RK, Brown KH, Allen LH. Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A-fortified rice in iron-deficient, pregnant, nightblind Nepali women. American Journal of Clinical Nutrition 2007;85(5):1375-84.
Guldholt 1991 {published data only}
Hillman 1963 {published data only}
Holly 1955 {published data only}
Hunt 1983 {published data only}
  • Hunt IF, Murphy NJ, Cleaver AE, Faraji B, Swendseid ME, Coulson AH, et al. Zinc supplementation during pregnancy: zinc concentration of serum and hair from low-income women of Mexican descent. American Journal of Clinical Nutrition 1983;37:572-82.
Hunt 1984 {published data only}
  • Hunt IF, Murphy NJ, Cleaver AE, Faraji B, Swendseid ME, Coulson AH, et al. Zinc supplementation during pregnancy: effects on selected blood constituents and on progress and outcome of pregnancy in low-income women of Mexican descent. American Journal of Clinical Nutrition 1984;40:508-21.
Hunt 1985 {published data only}
  • Hunt IF, Murphy NJ, Cleaver AE, Faraji B, Swendseid ME, Browdy BL, et al. Zinc supplementation during pregnancy in low-income teenagers of Mexican descent: effects on selected blood constituents and on progress and outcome of pregnancy. American Journal of Clinical Nutrition 1985;42:815-28.
Huybregts 2009 {published data only}
  • Huybregts L, Roberfroid D, Lanou H, Menten J, Meda N, Van Camp J, et al. Prenatal food supplementation fortified with multiple micronutrients increases birth length: a randomized controlled trial in rural Burkina Faso. American Journal of Clinical Nutrition 2009;90(6):1593-600.
Iannotti 2008 {published data only}
  • Iannotti LL, Zavaleta N, Leon Z, Shankar AH, Caulfield LE. Maternal zinc supplementation and growth in Peruvian infants. American Journal of Clinical Nutrition 2008;88(1):154-60.
ICMR 2000 {published data only}
  • Indian Council of Medical Research (ICMR) Collaborating Centers, Central Technical Co-ordinating Unit. Multicentric study of efficacy of periconceptional folic acid containing vitamin supplementation in prevention of open neural tube defects in India. Indian Journal of Medical Research 2000;112:206-11.
Kabir 2009 {published data only}
  • Kabir I, Khan AI, El Arifeen S, Alam DS, Persson LA. Effects of prenatal food and micronutrient supplementation and breastfeeding counseling on postnatal growth of rural Bangladeshi children. Pediatric Academic Societies Annual Meeting; 2009 May 2-5; Baltimore, USA. 2009.
Kubik 2004 {published data only}
  • Chelchowska M, Laskowska-Klita T, Kubik P, Leibschang J. The effect of vitamin-mineral supplementation on the level of MDA and activity of glutathione peroxidase and superoxide dismutase in blood of matched maternal-cord pairs [Wplyw suplementacji witaminowo-mineralnej na poziom MDA oraz aktywnosc peroksydazy glutationowej i dysmutazy ponadtlenkowej w krwi kobiet ciezarnych i krwi pepowinowej ich dzieci]. Przeglad Lekarski 2004;61(7):760-3.
  • Kubik P, Kowalska B, Laskowska-Klita T, Chelchowska M, Leibschang J. Effect of vitamin-mineral supplementation on the status of some microelements in pregnant women. Przeglad Lekarski 2004;61(7):764-8.
  • Laskowska-Klita T, Chelchowska M, Ambroszkiewicz J, Kubik P, Leibschang J. The effect of vitamin-mineral supplementation on vitamins D, A (beta-carotene) and E concentration in blood of matched maternal-cord pairs [Wplyw suplementacji witaminowo-mineralnej na stezenie witamin D, A (beta-karoten) i E w krwi kobiet ciezarnych i krwi pqpowinowej ich dzieci.]. Przeglad Lekarski 2004;61(7):755-9.
Kynast 1986 {published data only}
  • Kynast G, Langner K, Saling E. Clinical results of oral application of trace elements in risk pregnancies. Proceedings of 10th European Congress of Perinatal Medicine; 1986 Aug 12-16; Leipzig, Germany. 1986.
Lindström 2011 {published data only}
Ling 1996 {published data only}
  • Ling CD, Zhang ZJ, Chen ZL. Studies on nutritional effects of traditional Chinese tonics with strengthened nutrients on pregnant women and rats. Chung-Kuo Chung Hsi i Chieh Ho Tsa Chih 1996;16:270-3.
Lucia 2007 {published data only}
  • Lucia Bergmann R, Bergmann KE, Haschke-Becher E, Richter R, Dudenhausen JW, Barclay D, et al. Does maternal docosahexaenoic acid supplementation during pregnancy and lactation lower BMI in late infancy?. Journal of Perinatal Medicine 2007;35(4):295-300.
Ma 2008 {published data only}
  • Ma AG, Schouten EG, Zhang FZ, Kok FJ, Yang F, Jiang DC, et al. Retinol and riboflavin supplementation decreases the prevalence of anemia in Chinese pregnant women taking iron and folic acid supplements. Journal of Nutrition 2008;138(10):1946-50.
Mardones 2007 {published data only}
  • Mardones F, Urrutia MT, Villarroel L, Rioseco A, Castillo O, Rozowski J, et al. Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women. Public Health Nutrition 2007;11(1):30-40.
Marya 1987 {published data only}
Mathan 1979 {published data only}
  • Mathan BVI, Baker SH, Sood SK, Ramachandran K, Ramalingaswami V. WHO sponsored collaborative studies on nutritional anaemia in India. The effects of ascorbic acid and protein supplementation on the response of pregnant women to iron, pteroyglutamic acid and cyanocobalamin therapy. British Journal of Nutrition 1979;42:391-8.
Menon 1962 {published data only}
  • Menon MKK, Rajan L. Prophylaxis of anaemia in pregnancy. British Journal of Obstetrics and Gynaecology of the British Commonwealth 1962;12:382-9.
Merchant 2005 {published data only}
  • Merchant AT, Msamanga G, Villamor E, Saathoff E, O'Brien M, Hertzmark E, et al. Multivitamin supplementation of HIV- positive women during pregnancy reduces hypertension. Journal of Nutrition 2005;135(7):1776-81.
Merialdi 1999 {published data only}
  • Merialdi M, Caulfield LE, Zavaleta N, Figueroa A, DiPietro JA. Adding zinc to prenatal iron and folate tablets improves fetal neurobehavioral development. American Journal of Obstetrics and Gynecology 1999;180(2 Pt 1):483-90.
Muslimatun 2001a {published data only}
  • Muslimatun S, Schmidt MK, Schultink W, West CE, Hautvast JGAJ, Gross R, et al. Weekly supplementation with iron and vitamin A during pregnancy increases hemoglobin concentration but decreases serum ferritin concentration in Indonesian pregnant women. Journal of Nutrition 2001;131(1):85-90.
Muslimatun 2001b {published data only}
  • Muslimatun S, Schmidt MK, West CE, Schultink W, Hautvast JG, Karyadi D. Weekly vitamin A and iron supplementation during pregnancy increases vitamin A concentration of breast milk but not iron status in Indonesian lactating women. Journal of Nutrition 2001;131(10):2664-9.
Ochoa-Brust 2007 {published data only}
Park 1999 {published data only}
  • Park E, Wagenbichler P, Elmadfa I. Effects of multivitamin/mineral supplementation, at nutritional doses, on plasma antioxidant status and DNA damage estimated by sister chromatid exchanges in lymphocytes in pregnant women. International Journal for Vitamin and Nutrition Research 1999;69:396-402.
People's League 1946 {published data only}
  • People's League of Health. Nutrition of expectant and nursing mothers: interim report. Lancet 1942;2:10-2.
  • People's League of Health. The nutrition of expectant and nursing mothers in relation to maternal and infant mortality and morbidity. Journal of Obstetrics and Gynaecology of the British Empire 1946;53:498-509.
Ramirez-Velez 2011 {published data only}
  • Ramirez-Velez R, Romero M, Echeverri I, Ortega JG, Mosquera M, Salazar B, et al. A factorial randomized controlled trial to evaluate the effect of micronutrients supplementation and regular aerobic exercise on maternal endothelium-dependent vasodilatation and oxidative stress of the newborn. Trials 2011;12:60.
Robertson 1991 {published data only}
Sachdeva 1993 {published data only}
  • Sachdeva R, Mann SK. Impact of nutrition education and medical supervision on pregnancy outcome. Indian Pediatrics 1993;30(11):1309-14.
Sagaonkar 2009 {published data only}
  • Sagaonkar S, Sukhija S, Tayal R, Sagaonkar PD. Pregnancy induced iron deficiency and the evaluation and comparison of the efficacy and safety of ferrous fumarate and carbonyl iron in its treatment - PERFECT trial. Journal of Obstetrics and Gynecology of India 2009;59(6):552-62.
Schmidt 2001 {published data only}
  • Schmidt MK, Muslimatun S, West CE, Schultink W, Hautvast JG. Vitamin A and iron supplementation of Indonesian pregnant women benefits vitamin A status of their infants. British Journal of Nutrition 2001;86(5):607-15.
Schmidt 2002 {published data only}
  • Schmidt MK, Muslimatun S, Schultink W, West CE, Hautvast JG. Randomised double-blind trial of the effect of vitamin A supplementation of Indonesian pregnant women on morbidity and growth of their infants during the first year of life. European Journal of Clinical Nutrition 2002;56(4):338-46.
Semba 2000 {published data only}
  • Semba RD, Kumwenda N, Taha TE, Mtimavalye L, Broadhead R, Miotti PG, et al. Plasma and breast milk vitamin A as indicators of vitamin A status in pregnant women. International Journal for Vitamin and Nutrition Research 2000;70(6):271-7.
Semba 2001 {published data only}
Suharno 1993 {published data only}
Sun 2010 {published data only}
  • Sun YY, Ma AG, Yang F, Zhang FZ, Luo YB, Jiang DC, et al. A combination of iron and retinol supplementation benefits iron status, IL-2 level and lymphocyte proliferation in anemic pregnant women. Asia Pacific Journal of Clinical Nutrition 2010;19(4):513-9.
Suprapto 2002 {published data only}
Tanumihardjo 2002 {published data only}
  • Tanumihardjo SA. Vitamin A and iron status are improved by vitamin A and iron supplementation in pregnant Indonesian women. Journal of Nutrition 2002;132:1909-12.
Thauvin 1992 {published data only}
  • Thauvin E, Fusselier M, Arnaud J, Faure H, Favier M, Coudray C, et al. Effects of multivitamin mineral supplement on zinc and copper status during pregnancy. Biological Trace Element Research 1992;32:405-14.
Webb 2009 {published data only}
  • Webb AL, Aboud S, Furtado J, Murrin C, Campos H, Fawzi WW, et al. Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women. European Journal of Clinical Nutrition 2009;63(3):332-9.
Young 2010 {published data only}
  • Young SL, Blanco I, Hernandez-Cordero S, Pelto GH, Neufeld LM. Organoleptic properties, ease of use, and perceived health effects are determinants of acceptability of micronutrient supplements among poor Mexican women. Journal of Nutrition 2010;140(3):605-11.
Zavaleta 2000 {published data only}
  • Zavaleta N, Caulfield LE, Garcia T. Changes in iron status during pregnancy in peruvian women receiving prenatal iron and folic acid supplements with or without zinc. American Journal of Clinical Nutrition 2000;71(4):956-61.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Biggs 2011 {published data only}
  • Biggs BA. A randomised controlled trial to compare the impact on birth weight of daily iron-folic acid, twice weekly iron-folic acid and twice weekly multiple micronutrient supplementation for pregnant women in Ha Nam province, Vietnam. Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) (accessed 16 February 2011).
Cogswell 2006 {published data only}
  • Cogswell ME. Impact of prenatal vitamin/mineral supplements on perinatal mortality (planned trial). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 21 March 2006) 2006.
Dewey 2011 {published data only}
  • Dewey KG. Efficacy of lipid-based nutrient supplements (LNS) for pregnant and lactating women and their infants. ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 15 February 2011).
Fall 2007 {published data only}
  • Fall C. Mumbai maternal nutrition project (ongoing trial). Current Controlled Trials (http://controlled-trials.com) (accessed 15 February 2007).
Moore 2011 {published data only}
  • Moore S. Investigating the effects of pre-natal and infancy nutritional supplementation on infant immune development in The Gambia: the Early Nutrition and Immune Development (ENID) trial. Current Clinical Trials (http://www.current-trials.com) (accessed 8 July 2011).
West 2011 {published data only}
  • West KP. Antenatal micronutrient supplementation and infant survival (JiVitA-3). ClinicalTrials.gov (http://clinicaltrials.gov) (accessed 8 July 2011).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
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Allen 2005
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Alnwick 1998
Argiratos 1994
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Bell 1989
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Botto 2002
Caulfield 1997
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Caulfield 1998
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Chein 1996
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Dunn 1993
Egger 1997
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Gopalan 2002
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Hallberg 1991
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Jacob 1987
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Kramer 2003
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Lavender 1987
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Mason 2001
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McLaran 1982
O'Brien 2003
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Oppenheimer 2001
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Ramakrishnan 1999
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Rossander 1991
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Sandstrom 2001
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Shrimpton 2005
Stoltzfus 1995
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Stoltzfus 1997
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Suharno 1992
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West 1997
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West 1999
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WHO 1995
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