During pregnancy, when nutritional requirements are higher, micronutrient deficiencies can have adverse health and development consequences (e.g., preterm birth, small for gestational age, low birth weight). In many countries, it is recommended that women take prenatal supplements during pregnancy, typically containing a combination of iron and folic acid plus other vitamins and minerals.[1]
One meta-analysis, which included women of different gestational ages in low-income and middle-income countries, revealed that supplementation with a multiple-micronutrient (MMN) supplement (i.e., one containing 3 or more micronutrients) reduced the risk of low birth weight infants and the risk of babies considered small for gestational age more than supplementation with just iron and folic acid (IFA); this effect was especially pronounced with supplements containing more than 4 micronutrients. MMN supplementation also lowered the risk of stillbirth and the occurrence of diarrhea in children. Moreover, MMN slightly increased maternal and child serum retinol levels, slightly increased maternal zinc and vitamin B12 levels, and improved executive function scores in children, compared to IFA. However, no difference was noted for all other studied outcomes, including maternal or perinatal mortality, risk of miscarriage, risk of congenital anomalies, preterm births, risk of C-section, child general intelligence, motor functioning, verbal comprehension, or language.[1] While studies such as this one suggest benefits from taking an MMN prenatal supplement instead of one that only contains folic acid and iron, variations in methods and interventions used, such as supplement composition, may need to be addressed before drawing generalized conclusions.
Whether MMN supplements are more beneficial than just IFA in upper-middle-income and high-income countries remains unclear: it likely varies depending on the intake of essential micronutrients from the diet.[2]