Multiple Micronutrient Supplementation during Pregnancy in Low-Income Countries: A Meta-Analysis of Effects on Stillbirths and on Early and Late Neonatal Mortality

BACKGROUND: Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes. OBJECTIVE: To 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. METHODS: Twelve 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. RESULTS: Supplementation providing approximately I RDA of multiple micronutrients did not decrease the risk of stillbirth (OR = 1.01; 95% CI, 0.88 to 1.16),…