This Cochrane Review findings suggest a positive impact of multiple micronutrient (MMN) supplementation with iron and folic acid on several birth outcomes. MMN supplementation in pregnancy led to a reduction in babies considered low birth weight, and probably led to a reduction in babies considered small for gestational age (SGA). In addition, MMN probably reduced preterm births. No important benefits or harms of MMN supplementation were found for mortality outcomes (stillbirths, perinatal and neonatal mortality). These findings may provide some basis to guide the replacement of iron and folic acid supplements with MMN supplements for pregnant women residing in low‐ and middle‐income countries.