This study assessed the effects of prenatal multiple micronutrient supplementation (MMS) and an early invitation to food supplementation on maternal hemoglobin level, birth weight, and infant mortality in Bangladesh. Pregnant women were randomized into 6 groups; iron-folic acid (IFA) with 30 mg of iron and 400 μg of folic acid, IFA with 60 mg of iron and 400 μg of folic acid, or MMS containing a daily allowance of 15 micronutrients, including 30 mg of iron and 400 μg of folic acid, combined with food supplementation (608 kcal 6 days per week) either by early invitation (9 weeks’ gestation) or usual invitation (20 weeks’ gestation). The early invitation with MMS group had an infant mortality rate of 16.8 per 1000 live births vs 44.1 per 1000 live births for usual invitation with IFA with 60 mg of iron and 400 μg of folic acid. Early invitation with MMS group had an under 5-year mortality rate of 18 per 1000 live births compared to 54 per 1000 live births for usual invitation with IFA with 60 mg of iron and 400 μg of folic acid. Usual invitation with MMS group had the highest incidence of spontaneous abortions and the highest infant mortality rate. Results showed that among pregnant women in poor communities in Bangladesh, treatment with multiple micronutrients, including IFA combined with early food supplementation, vs a standard program that included treatment with iron and folic acid and usual food supplementation, resulted in decreased childhood mortality.
